Adrenal Support Formula with 14 researched nutrients
Our product developers were assigned the task of developing the most advanced adrenal support product based on published research. After a thorough review of the literature, they formulated Energy Multi-Plex™ --- the total energy formula. A favorite among doctors and patients, Energy Multi-Plex™ is a reasonably priced answer to many people's dreams of more energy.
“I have improved energy after supplementing with NT Factor Energy and Energy Multi-Plex. Especially notable are the increased maximal sudden power, endurance, and ability to recover during exercise and also for the next day events - for example in distance bicycling on hilly roads and weight lifting and aerobic exercising at the Y.
These two Researched Nutritionals products were added to a thorough treatment program for a longer-term fatigue illness from tick borne infection complex illness in the later, more recent stages of therapy. I think the products address some of what we know about mitochondrial damage in the longer-term fatigue- like syndromes and look forward to discussing this further with others interested in increased energy. I have no conflicts of interest in my dialogues regarding Researched Nutritionals products.” --- H. Smith MD
Each bottle provides a one month supply of the following complexes and health benefits:
Energymax™ Complex:
Targeted blend of D-ribose, panax ginseng which
• promotes healthy energy levels by raising the level of the body’s energy fuel, ATP
• supports healthy cognitive performance
MuscularEnergy™ Complex:
Combination of malic acid and rhodiola rosea which
• plays a key role in energy producing Kreb’s Cycle
• has an adaptogenic affect to support physical activity
Mitrochondria Energizer™ Complex:
Powerful duo of acetyl-L-carnitine and alpha lipoic acid which
• acts as a catalyst for ATP production in mitochondria
• improves mitochondrial function while promoting healthy cognitive function
Metabolism Plus™ Complex:
Natural, non-stimulation blend of pyruvic acid and 7-Keto DHEA which
• naturally increases, without artificial stimulation, resting metabolism
• multiple studies
show increased fat utilization (fat loss) as an energy source
• promotes fat loss through thermogenesis
HeartStrong™ Complex:
High potency Co Q10 and L-Taurine which
• is used by the body to transform food into adenosine triphosphate (ATP), the energy on which the body runs
• promotes healthy heart and gum tissue
• modulates the immune system
• promotes healthy heart beat and cell wall stability
Key Nutrient Blend:
pantothenic acid, vitamin B-12, magnesium and potassium which
• are essential nutrients involved in producing, transporting and releasing energy from fat
• promotes healthy neuromuscular function and muscle contractions
Showing posts with label chronic fatigue. Show all posts
Showing posts with label chronic fatigue. Show all posts
Wednesday, October 26, 2011
Optimized Energy for Serious Mitochondrial Needs
ATP Fuel™ - NEW
Optimized Energy for Serious Mitochondrial Needs
ATP Fuel™ is designed to support the Krebs Cycle of cellular energy production. The Krebs Cycle takes place inside the mitochondria or “power plant” of the cell and it is the body’s primary energy producer.
ATP Fuel™ offers the top three energy nutrients and cofactors synergistically combined for maximum mitochondrial performance and energy production:
NT Factor Energy™
NADH
CoQ10
ATP Fuel™ starts with the base of our highly acclaimed NT Factor Energy™, and adds the two other well-researched energy producing nutrients, NADH and CoQ10 into one convenient and power-producing formula. Plus ATP Fuel™ is available in capsules.
NT Factor Energy™- to repair mitochondrial membranes NT Factor Energy™ was developed as a phospholipid delivery system to repair mitochondrial membranes that have been compromised due to acute and/or long-term health challenges.
Mitochondrial membranes contain their own DNA. If these membranes are damaged and not able to self-repair, they rely on healthy cells to donate their phospholipids. However, if there is a cascading impact of damaged cells splitting, the end result is a less than optimal energy level.
The product's efficacy is based on our proprietary method of extracting and stabilizing the phospholipids, and delivering them intact in the lower intestine for proper absorption. Phospholipids are very unstable and often oxidize in the manufacturing process or in the digestive tract before they can be presented for absorption in the lower intestine. After we stabilize the phospholipids, we wrap them in probiotics and prebiotics. Next, we add minerals and other nutrients to assist in the Krebs Energy Cycle and absorption. When the capsule reaches the lower intestine, the pre and probiotics are released first to promote a healthy flora. We follow this with the release of the NT Factor portion, whose matrix very closely matches that of the gastro intestinal mucosa. As these phospholipids are transported from cell to cell, they are absorbed into the outer and inner mitochondrial membranes --- allowing the mitochondria to provide its natural and healthy level of energy.
A healthy mitochondrial membrane:
allows more nutrients into the mitochondria to support the Krebs Cycle of energy production
is essential for the electron transport chain to efficiently produce healthy levels of ATP
promotes healthier (reduced) level of oxidative stress
NADH - to convert food into energy
NADH is the reduced (electron- energy rich) coenzyme form of vitamin B3 or B-Nicotinamide Adenine Dinucleotide. This "reducing" power (its ability to donate electrons) is what drives ATP production.
NADH is fundamental in the chemical process of converting the food we eat into cellular energy. Each unit of NADH creates three units of ATP (the body's energy fuel).
Studies conducted in Europe indicated that NADH promotes healthy energy levels and emotional balance.
NADH is notoriously unstable. As part of our proprietary formula, we stabilize our NADH with chlorophyll, followed by microencapsulation process to resist gastric acids.
Coenzyme Q10 - for ATP energy production
Coenzyme Q10 (CoQ10) is a compound found naturally in the energy-producing center of the cell known as the mitochondria. CoQ10 is involved in the making of ATP. ATP serves as the cell's major energy source and drives a number of biological processes including muscle contraction and the production of protein. CoQ10 also works as an antioxidant.
CoQ10 promotes healthy energy levels, enhances the immune system, and acts as an antioxidant. A growing body of research suggests that using coenzyme Q10 supplements alone or in combination with other drug therapies and nutritional supplements supports the body’s health in promoting a healthy heart, promoting healthy periodontal (gum) condition, and in supporting cognitive and nerve health.*
Mitochondria - what are they & why are they so important? Mitochondria are the primary energy producers in the body. The typical cell contains an average of 1,000 mitochondria. Given that there are 10 to the 13th power cells in a healthy adult, healthy and productive mitochondria are critical to maintain the body's energy and resilience.
Recent studies have shown the importance to maintaining healthy MTDNA, the DNA which resides inside the mitochondria. Unlike standard DNA which has histones and introns to protect it from free radical damage, the mitochondrial DNA does not have this protective mechanism so it is much more exposed and more susceptible to oxidative damage (ROS or reactive oxidative stress). And since mitochondrial cell division takes place approximately every five to six days and replicates the damage existing in the old cells, the damaged MTDNA spreads rapidly. This is what eventually depletes the patient's energy level and may lead to abnormal cellular formation.
Optimized Energy for Serious Mitochondrial Needs
ATP Fuel™ is designed to support the Krebs Cycle of cellular energy production. The Krebs Cycle takes place inside the mitochondria or “power plant” of the cell and it is the body’s primary energy producer.
ATP Fuel™ offers the top three energy nutrients and cofactors synergistically combined for maximum mitochondrial performance and energy production:
NT Factor Energy™
NADH
CoQ10
ATP Fuel™ starts with the base of our highly acclaimed NT Factor Energy™, and adds the two other well-researched energy producing nutrients, NADH and CoQ10 into one convenient and power-producing formula. Plus ATP Fuel™ is available in capsules.
NT Factor Energy™- to repair mitochondrial membranes NT Factor Energy™ was developed as a phospholipid delivery system to repair mitochondrial membranes that have been compromised due to acute and/or long-term health challenges.
Mitochondrial membranes contain their own DNA. If these membranes are damaged and not able to self-repair, they rely on healthy cells to donate their phospholipids. However, if there is a cascading impact of damaged cells splitting, the end result is a less than optimal energy level.
The product's efficacy is based on our proprietary method of extracting and stabilizing the phospholipids, and delivering them intact in the lower intestine for proper absorption. Phospholipids are very unstable and often oxidize in the manufacturing process or in the digestive tract before they can be presented for absorption in the lower intestine. After we stabilize the phospholipids, we wrap them in probiotics and prebiotics. Next, we add minerals and other nutrients to assist in the Krebs Energy Cycle and absorption. When the capsule reaches the lower intestine, the pre and probiotics are released first to promote a healthy flora. We follow this with the release of the NT Factor portion, whose matrix very closely matches that of the gastro intestinal mucosa. As these phospholipids are transported from cell to cell, they are absorbed into the outer and inner mitochondrial membranes --- allowing the mitochondria to provide its natural and healthy level of energy.
A healthy mitochondrial membrane:
allows more nutrients into the mitochondria to support the Krebs Cycle of energy production
is essential for the electron transport chain to efficiently produce healthy levels of ATP
promotes healthier (reduced) level of oxidative stress
NADH - to convert food into energy
NADH is the reduced (electron- energy rich) coenzyme form of vitamin B3 or B-Nicotinamide Adenine Dinucleotide. This "reducing" power (its ability to donate electrons) is what drives ATP production.
NADH is fundamental in the chemical process of converting the food we eat into cellular energy. Each unit of NADH creates three units of ATP (the body's energy fuel).
Studies conducted in Europe indicated that NADH promotes healthy energy levels and emotional balance.
NADH is notoriously unstable. As part of our proprietary formula, we stabilize our NADH with chlorophyll, followed by microencapsulation process to resist gastric acids.
Coenzyme Q10 - for ATP energy production
Coenzyme Q10 (CoQ10) is a compound found naturally in the energy-producing center of the cell known as the mitochondria. CoQ10 is involved in the making of ATP. ATP serves as the cell's major energy source and drives a number of biological processes including muscle contraction and the production of protein. CoQ10 also works as an antioxidant.
CoQ10 promotes healthy energy levels, enhances the immune system, and acts as an antioxidant. A growing body of research suggests that using coenzyme Q10 supplements alone or in combination with other drug therapies and nutritional supplements supports the body’s health in promoting a healthy heart, promoting healthy periodontal (gum) condition, and in supporting cognitive and nerve health.*
Mitochondria - what are they & why are they so important? Mitochondria are the primary energy producers in the body. The typical cell contains an average of 1,000 mitochondria. Given that there are 10 to the 13th power cells in a healthy adult, healthy and productive mitochondria are critical to maintain the body's energy and resilience.
Recent studies have shown the importance to maintaining healthy MTDNA, the DNA which resides inside the mitochondria. Unlike standard DNA which has histones and introns to protect it from free radical damage, the mitochondrial DNA does not have this protective mechanism so it is much more exposed and more susceptible to oxidative damage (ROS or reactive oxidative stress). And since mitochondrial cell division takes place approximately every five to six days and replicates the damage existing in the old cells, the damaged MTDNA spreads rapidly. This is what eventually depletes the patient's energy level and may lead to abnormal cellular formation.
Friday, February 25, 2011
Corvalen & CorvalenM New Product Label
We recently learned that Bioenergy is no longer selling these products directly to patients and have given up control of the distribution of these products to Douglas Laboratories. They have new packaging but this is still the same product as before when under Bioenergy. Corvalen Ribose and CorvalenM can still be purchased through health care practitioners or on the internet.
Tuesday, June 22, 2010
Relief from Fatigue
Buy Corvalen Ribose at best lowest price FREE shipping.
Corvalen is a non-prescription medical food that specifically addresses a nutritional deficiency associated with particular diseases that result in fatigue and pain. Using GRAS-approved Corvalen, with the active ingredient ribose, patients can overcome this fatigue and pain more quickly.
Corvalen aids patients suffering from compromised heart function, Fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS) by restoring depleted energy reserves at a cellular level. Clinically-proven studies have shown a reduction of fatigue, muscle soreness, stiffness and pain with patients that use Corvalen.
Scientific and clinical studies have repeatedly shown that Corvalen, with the active ingredient ribose, can restore energy and improve function in ischemic, hypoxic, and failing hearts. Oxygen deprivation causes hearts to use energy faster than it can be replaced through normal processes of tissue energy turnover. The result is a depletion of cellular energy reserves translating to loss of heart function.
Millions of Americans suffer the affects of coronary artery disease, and the prevalence of congestive heart failure is reaching epidemic proportions. Recent research has also proven that high-intensity endurance exercise places a considerable strain on the heart, leading to a loss of diastolic heart function that persists for several weeks to months following an event. Other research, conducted at the Mayo Clinic and published in the Journal of the American Medical Association, showed that an average of 26% of the population, male and female, have symptoms of cardiac diastolic dysfunction. More than half of those affected are unaware of their condition, but all are at risk for developing congestive heart failure.
When hearts lose energy, they first suffer a loss of diastolic function. The diastolic phase of the heartbeat is the relaxation phase, during which the heart fills with blood for the next heartbeat. A loss of diastolic capacity means less blood will circulate to the body during each beat, and frequently leads to a thickening and expansion of the heart muscle, known as hypertrophy. The result of chronic diastolic dysfunction can be congestive heart failure. For patients, the progressive consequence of the disease is shortness of breath, loss of exercise capacity, overwhelming fatigue, etc.
Corvalen increases cardiac energy to help fuel the heart. For patients, this can mean more energy and a higher quality of life. For athletes, it can enhance recovery following strenuous exercise.
Corvalen is a non-prescription medical food that specifically addresses a nutritional deficiency associated with particular diseases that result in fatigue and pain. Using GRAS-approved Corvalen, with the active ingredient ribose, patients can overcome this fatigue and pain more quickly.
Corvalen aids patients suffering from compromised heart function, Fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS) by restoring depleted energy reserves at a cellular level. Clinically-proven studies have shown a reduction of fatigue, muscle soreness, stiffness and pain with patients that use Corvalen.
Scientific and clinical studies have repeatedly shown that Corvalen, with the active ingredient ribose, can restore energy and improve function in ischemic, hypoxic, and failing hearts. Oxygen deprivation causes hearts to use energy faster than it can be replaced through normal processes of tissue energy turnover. The result is a depletion of cellular energy reserves translating to loss of heart function.
Millions of Americans suffer the affects of coronary artery disease, and the prevalence of congestive heart failure is reaching epidemic proportions. Recent research has also proven that high-intensity endurance exercise places a considerable strain on the heart, leading to a loss of diastolic heart function that persists for several weeks to months following an event. Other research, conducted at the Mayo Clinic and published in the Journal of the American Medical Association, showed that an average of 26% of the population, male and female, have symptoms of cardiac diastolic dysfunction. More than half of those affected are unaware of their condition, but all are at risk for developing congestive heart failure.
When hearts lose energy, they first suffer a loss of diastolic function. The diastolic phase of the heartbeat is the relaxation phase, during which the heart fills with blood for the next heartbeat. A loss of diastolic capacity means less blood will circulate to the body during each beat, and frequently leads to a thickening and expansion of the heart muscle, known as hypertrophy. The result of chronic diastolic dysfunction can be congestive heart failure. For patients, the progressive consequence of the disease is shortness of breath, loss of exercise capacity, overwhelming fatigue, etc.
Corvalen increases cardiac energy to help fuel the heart. For patients, this can mean more energy and a higher quality of life. For athletes, it can enhance recovery following strenuous exercise.
Corvalen Ribose - How it Works
Buy Corvalen Ribose at the best lowest price with free shipping.
Corvalen energy supplement and clinical nutrition products contain D-ribose (or simply ribose). Ribose is vital for your body to make the primary energy compound, adenosine triphosphate (ATP). ATP gives your body the energy it needs to stay healthy, overcome fatigue, and regain the vitality you need to live a normal, active life. That is why ATP is called the "energy currency" of the cell.
D-ribose, or simply ribose, is a five-carbon monosaccharide that is made in every cell in your body. Ribose stimulates the metabolic pathway used by the body to make a class of compounds called purines and pyrimidines. These compounds are essential for the body's production of many vital constituents, including the genetic material DNA and RNA, and the vital energy compound ATP.
The ribose in Corvalen helps energize your heart and muscles by increasing energy on a cellular level. Aging, strenuous exercise or overexertion, and many metabolic or physiological conditions can drain ATP from your tissue and affect how well your body makes and uses energy. Science has proven that ribose is a necessary ingredient for rebuilding energy in our bodies. So, without ribose we cannot make the energy we need to stay healthy.
Unfortunately, hearts, muscles, and other vital tissues in the body cannot make ribose very quickly, and ribose is not stored in our cells and tissues. That's why supplementing with Corvalen as directed will help your cells make energy quickly, safely, and naturally. This means you can feel more energetic, stronger, and healthier every day.
Corvalen energy supplement and clinical nutrition products contain D-ribose (or simply ribose). Ribose is vital for your body to make the primary energy compound, adenosine triphosphate (ATP). ATP gives your body the energy it needs to stay healthy, overcome fatigue, and regain the vitality you need to live a normal, active life. That is why ATP is called the "energy currency" of the cell.
D-ribose, or simply ribose, is a five-carbon monosaccharide that is made in every cell in your body. Ribose stimulates the metabolic pathway used by the body to make a class of compounds called purines and pyrimidines. These compounds are essential for the body's production of many vital constituents, including the genetic material DNA and RNA, and the vital energy compound ATP.
The ribose in Corvalen helps energize your heart and muscles by increasing energy on a cellular level. Aging, strenuous exercise or overexertion, and many metabolic or physiological conditions can drain ATP from your tissue and affect how well your body makes and uses energy. Science has proven that ribose is a necessary ingredient for rebuilding energy in our bodies. So, without ribose we cannot make the energy we need to stay healthy.
Unfortunately, hearts, muscles, and other vital tissues in the body cannot make ribose very quickly, and ribose is not stored in our cells and tissues. That's why supplementing with Corvalen as directed will help your cells make energy quickly, safely, and naturally. This means you can feel more energetic, stronger, and healthier every day.
Wednesday, June 9, 2010
Reducing the symptoms of fibromyalgia
According to research published over the past few months, several different energy producing and antioxidant supplements might be beneficial for reducing the symptoms of fibromyalgia.
Creatine and Co-EnzymeQ10 (Co-Q10) help provide fuel to your cells. More importantly, Co-Q10 helps power up your energy factories, your mitochondria, to produce more fuel. However, additional research shows that the mitochondria in fibro patients might be under attack from molecules causing oxidative stress, which can damage cells in your cardiovascular system, your brain, or other tissues in the body. Here is where fat-soluble antioxidants such as omega-3 fatty acids and vitamin E might be beneficial.
Creatine and Co-EnzymeQ10 (Co-Q10) help provide fuel to your cells. More importantly, Co-Q10 helps power up your energy factories, your mitochondria, to produce more fuel. However, additional research shows that the mitochondria in fibro patients might be under attack from molecules causing oxidative stress, which can damage cells in your cardiovascular system, your brain, or other tissues in the body. Here is where fat-soluble antioxidants such as omega-3 fatty acids and vitamin E might be beneficial.
Friday, June 4, 2010
Soothe & Relaxx™ Soft Tissue & Stress Support
Soothe & Relaxx™ Soft Tissue & Stress Support
Has anybody tried this? My doctor put me on this for Lyme disease and it works great for me. It also works great for the fibromyalgia symptoms and anything to do with soft tissue pain, stress and relaxation. Thought I would share the information with you.
Product Description
Soft tissue, joint & muscle support with Relaxx™ Complex to calm the mind. (180 capsules)
Special Dietary Usefulness:
Under a physician’s direction, Soothe & Relaxx™ may have special dietary usefulness for individuals suffering from fibromyalgia and other chronic illnesses with soft tissue, joint and muscle pain.
Soothe & Relaxx™ was developed to meet the combination of needs that many chronically ill patients experience: pain and anxiety. The product addresses pain as a result of soft tissue or joint injury and the concomitant anxiety often associated with long-term health issues. The Relaxx™ Complex is designed to take the edge off versus being a sedating micro-formula. This is a favorite of patients who feel the benefit fairly quickly.
Each bottle provides a one month supply of the following complexes and health benefits:
Pro Joint Soothers™:
Proprietary blend of glucosamine sulfate, MSM, chrondroitin sulfate, hyaluronic acid which supports connective tissue, lubricates joints, promotes joint resilience, elasticity and overall strength.
ExInflame™ Complex:
Proprietary blend of White Willow Bark, Boswellin, Curcumin Extract, Holy Basil which promotes a healthy inflammation response.
Muscle & Leg Calmer™:
Proprietary blend of magnesium hydroxide and malic acid which calms muscle contractions and relaxes the body's muscles.
Relaxx™ Complex:
Proprietary blend of 5HTP, Valerian, Lemon Balm, Passion Flower, German Chamomile which relaxes & calms the mind, and promotes healthy sleep patterns.
Suggested Use:
As a dietary supplement, take two capsules three times per day or as directed by your health care professional.
Has anybody tried this? My doctor put me on this for Lyme disease and it works great for me. It also works great for the fibromyalgia symptoms and anything to do with soft tissue pain, stress and relaxation. Thought I would share the information with you.
Product Description
Soft tissue, joint & muscle support with Relaxx™ Complex to calm the mind. (180 capsules)
Special Dietary Usefulness:
Under a physician’s direction, Soothe & Relaxx™ may have special dietary usefulness for individuals suffering from fibromyalgia and other chronic illnesses with soft tissue, joint and muscle pain.
Soothe & Relaxx™ was developed to meet the combination of needs that many chronically ill patients experience: pain and anxiety. The product addresses pain as a result of soft tissue or joint injury and the concomitant anxiety often associated with long-term health issues. The Relaxx™ Complex is designed to take the edge off versus being a sedating micro-formula. This is a favorite of patients who feel the benefit fairly quickly.
Each bottle provides a one month supply of the following complexes and health benefits:
Pro Joint Soothers™:
Proprietary blend of glucosamine sulfate, MSM, chrondroitin sulfate, hyaluronic acid which supports connective tissue, lubricates joints, promotes joint resilience, elasticity and overall strength.
ExInflame™ Complex:
Proprietary blend of White Willow Bark, Boswellin, Curcumin Extract, Holy Basil which promotes a healthy inflammation response.
Muscle & Leg Calmer™:
Proprietary blend of magnesium hydroxide and malic acid which calms muscle contractions and relaxes the body's muscles.
Relaxx™ Complex:
Proprietary blend of 5HTP, Valerian, Lemon Balm, Passion Flower, German Chamomile which relaxes & calms the mind, and promotes healthy sleep patterns.
Suggested Use:
As a dietary supplement, take two capsules three times per day or as directed by your health care professional.
Thursday, June 3, 2010
Lyme Disease & Common Co-Infections
Lyme Disease & Common Co-Infections
Short Symptom List
Borrelia, Babesia, Bartonella, and Ehrlichia
The following symptoms were excerpted from Diagnostic Hints And Treatment
Guidelines For Lyme And Other Tick Borne Illnesses, by Joseph J. Burrascano Jr.,M.D. (Fourteenth Edition, November, 2002). Available online at www.ilads.org/burrascano_1102.html
Borrelia
(Borreliosis, neuroborreliosis; also known as Lyme Disease)
Spread primarily though the bite of infected ticks that live on a wide range of mammalian species; secondary human-to-human transmission through semen, breast milk, and possibly in utero.
**Bladder dysfunction
**Burning or stabbing sensations
**Cardiac impairment
**Change in bowel function
**Chest pain
**Confusion
**Depression
**Difficulty thinking
**Difficulty with concentration and reading
**Difficulty with speech, writing
**Difficulty finding words; name blocking
**Disorientation: getting lost, going to wrong places
**Disturbed sleep: too much, too little, fractionated, early awakening
**Ears/Hearing: buzzing, ringing, ear pain, sound sensitivity
**Exaggerated symptoms or worse hangover from alcohol
**Eyes/Vision: double, blurry, increased floaters, light sensitivity
**Facial paralysis (Bell's palsy)
**Fatigue, tiredness, poor stamina
**Forgetfulness
**Headache
**Heart block
**Heart murmur
**Heart palpitations
**Heart valve prolapse
**Increased motion sickness
**Irritability
**Irritable bladder
**Joint pain or swelling
**Lightheadedness
**Mood swings
**Muscle pain or cramps
**Neck creaks & cracks
**Neck stiffness, pain
**Numbness
**Pelvic pain
**Poor attention
**Poor balance
**Poor short-term memory
**Problem absorbing new information
**Pulse skips
**Rib soreness
**Sexual dysfunction or loss of libido
**Shooting pains
**Shortness of breath; cough
**Skin hypersensitivity
**Sore throat
**Stiffness of the joints or back
**Swollen glands
**Testicular pain
**Tingling
**Tremor
**Twitching of the face or other muscles
**Unavoidable need to sit or lay down
**Unexplained breast pain
**Unexplained fevers, sweats, chills or flushing
**Unexplained hair loss
**Unexplained menstrual irregularity'
**Unexplained milk production
**Unexplained weight loss or gain
**Upset Stomach or abdominal pain
**Vertigo
**Wooziness
Babesia Babesiosis)
Babesia is a protozoan spread by ticks, blood transfusion, and in utero. Despite there being 13 known forms to date, current testing only looks for two of them.
**Air hunger
**Cough
**Fatigue
**Fevers
**Headache
**Hemolysis
**Imbalance without true vertigo
**Mild encephalopathy
**Shaking chills
**Sweats
Bartonella (Bartonellosis, also known as cat scratch fever)
Spread by bites from infected ticks and in utero
**abnormal liver enzymes
**encephalopathy
**endocarditis
**flu-like malaise
**headache
**hemolysis with anemia
**hepatomegaly
**high fever
**immune deficiency
**jaundice
**lymphadenopathy
**myalgias
**myocarditis
**papular or angiomatous rash
**somnolence
**sore throat
**splenomegaly
**weakened immune response
Ehrlichia (Ehrlichiosis)
Bites from infected ticks
**elevated liver enzymes
**headaches
**myalgias
**ongoing fatigue
**persistent leukopenia
**thrombocytopenia
Printed from www.anapsid.org/lyme/symptoms/tbi-symptoms.html
More information on Lyme and other tickborne diseases:
www.calda.intranets.com
www.ilads.org
www.lymenet.org
Short Symptom List
Borrelia, Babesia, Bartonella, and Ehrlichia
The following symptoms were excerpted from Diagnostic Hints And Treatment
Guidelines For Lyme And Other Tick Borne Illnesses, by Joseph J. Burrascano Jr.,M.D. (Fourteenth Edition, November, 2002). Available online at www.ilads.org/burrascano_1102.html
Borrelia
(Borreliosis, neuroborreliosis; also known as Lyme Disease)
Spread primarily though the bite of infected ticks that live on a wide range of mammalian species; secondary human-to-human transmission through semen, breast milk, and possibly in utero.
**Bladder dysfunction
**Burning or stabbing sensations
**Cardiac impairment
**Change in bowel function
**Chest pain
**Confusion
**Depression
**Difficulty thinking
**Difficulty with concentration and reading
**Difficulty with speech, writing
**Difficulty finding words; name blocking
**Disorientation: getting lost, going to wrong places
**Disturbed sleep: too much, too little, fractionated, early awakening
**Ears/Hearing: buzzing, ringing, ear pain, sound sensitivity
**Exaggerated symptoms or worse hangover from alcohol
**Eyes/Vision: double, blurry, increased floaters, light sensitivity
**Facial paralysis (Bell's palsy)
**Fatigue, tiredness, poor stamina
**Forgetfulness
**Headache
**Heart block
**Heart murmur
**Heart palpitations
**Heart valve prolapse
**Increased motion sickness
**Irritability
**Irritable bladder
**Joint pain or swelling
**Lightheadedness
**Mood swings
**Muscle pain or cramps
**Neck creaks & cracks
**Neck stiffness, pain
**Numbness
**Pelvic pain
**Poor attention
**Poor balance
**Poor short-term memory
**Problem absorbing new information
**Pulse skips
**Rib soreness
**Sexual dysfunction or loss of libido
**Shooting pains
**Shortness of breath; cough
**Skin hypersensitivity
**Sore throat
**Stiffness of the joints or back
**Swollen glands
**Testicular pain
**Tingling
**Tremor
**Twitching of the face or other muscles
**Unavoidable need to sit or lay down
**Unexplained breast pain
**Unexplained fevers, sweats, chills or flushing
**Unexplained hair loss
**Unexplained menstrual irregularity'
**Unexplained milk production
**Unexplained weight loss or gain
**Upset Stomach or abdominal pain
**Vertigo
**Wooziness
Babesia Babesiosis)
Babesia is a protozoan spread by ticks, blood transfusion, and in utero. Despite there being 13 known forms to date, current testing only looks for two of them.
**Air hunger
**Cough
**Fatigue
**Fevers
**Headache
**Hemolysis
**Imbalance without true vertigo
**Mild encephalopathy
**Shaking chills
**Sweats
Bartonella (Bartonellosis, also known as cat scratch fever)
Spread by bites from infected ticks and in utero
**abnormal liver enzymes
**encephalopathy
**endocarditis
**flu-like malaise
**headache
**hemolysis with anemia
**hepatomegaly
**high fever
**immune deficiency
**jaundice
**lymphadenopathy
**myalgias
**myocarditis
**papular or angiomatous rash
**somnolence
**sore throat
**splenomegaly
**weakened immune response
Ehrlichia (Ehrlichiosis)
Bites from infected ticks
**elevated liver enzymes
**headaches
**myalgias
**ongoing fatigue
**persistent leukopenia
**thrombocytopenia
Printed from www.anapsid.org/lyme/symptoms/tbi-symptoms.html
More information on Lyme and other tickborne diseases:
www.calda.intranets.com
www.ilads.org
www.lymenet.org
Basic Information about Lyme Disease
If you have been diagnosed with fibromyalgia, chronic fatigue syndrome, MS, early Alzheimers or early dementia, parkinson's disease or Lou Gerhig's disease, it is recommended that you get tested for Lyme disease. Lyme disease is the great pretender and can mimic these other diseases. Lyme disease is hard to diagnose and lab testing is not reliable. Your best bet for lab testing is IgeneX labs (tick speciality lab).
Basic Information about Lyme Disease
by The International Lyme and Associated Diseases Society
1. Lyme disease is transmitted by the bite of a tick, and the disease is prevalent across the United States and throughout the world. Ticks know no borders and respect no boundaries. A patient's county of residence does not accurately reflect his or her Lyme disease risk because people travel, pets travel, and ticks travel. This creates a dynamic situation with many opportunities for exposure to Lyme disease for each individual.
2. Lyme disease is a clinical diagnosis. The disease is caused by a spiral-shaped bacteria (spirochete) called Borrelia burgdorferi. The Lyme spirochete can cause infection of multiple organs and produce a wide range of symptoms. Case reports in the medical literature document the protean manifestations of Lyme disease, and familiarity with its varied presentations is key to recognizing disseminated disease.
3. Fewer than 50% of patients with Lyme disease recall a tick bite. In some studies this number is as low as 15% in culture-proven infection with the Lyme spirochete.
4. Fewer than 50% of patients with Lyme disease recall any rash. Although the erythema migrans (EM) or “bull’s-eye” rash is considered classic, it is not the most common dermatologic manifestation of early-localized Lyme infection. Atypical forms of this rash are seen far more commonly. It is important to know that the EM rash is pathognomonic of Lyme disease and requires no further verification prior to starting an appropriate course of antibiotic therapy.
5. The Centers for Disease Control and Prevention (CDC) surveillance criteria for Lyme disease were devised to track a narrow band of cases for epidemiologic purposes. As stated on the CDC website, the surveillance criteria were never intended to be used as diagnostic criteria, nor were they meant to define the entire scope of Lyme disease.
6. The ELISA screening test is unreliable. The test misses 35% of culture proven Lyme disease (only 65% sensitivity) and is unacceptable as the first step of a two-step screening protocol. By definition, a screening test should have at least 95% sensitivity.
7. Of patients with acute culture-proven Lyme disease, 20–30% remain seronegative on serial Western Blot sampling. Antibody titers also appear to decline over time; thus while the Western Blot may remain positive for months, it may not always be sensitive enough to detect chronic infection with the Lyme spirochete. For “epidemiological purposes” the CDC eliminated from the Western Blot analysis the reading of bands 31 and 34. These bands are so specific to Borrelia burgdorferi that they were chosen for vaccine development. Since a vaccine for Lyme disease is currently unavailable, however, a positive 31 or 34 band is highly indicative of Borrelia burgdorferi exposure. Yet these bands are not reported in commercial Lyme tests.
8. When used as part of a diagnostic evaluation for Lyme disease, the Western Blot should be performed by a laboratory that reads and reports all of the bands related to Borrelia burgdorferi. Laboratories that use FDA approved kits (for instance, the Mardx Marblot®) are restricted from reporting all of the bands, as they must abide by the rules of the manufacturer. These rules are set up in accordance with the CDCs surveillance criteria and increase the risk of false-negative results. The commercial kits may be useful for surveillance purposes, but they offer too little information to be useful in patient management.
9. There are 5 subspecies of Borrelia burgdorferi, over 100 strains in the US, and 300 strains worldwide. This diversity is thought to contribute to the antigenic variability of the spirochete and its ability to evade the immune system and antibiotic therapy, leading to chronic infection.
10. Testing for Babesia, Anaplasma, Ehrlichia and Bartonella (other tick-transmitted organisms) should be performed. The presence of co-infection with these organisms points to probable infection with the Lyme spirochete as well. If these coinfections are left untreated, their continued presence increases morbidity and prevents successful treatment of Lyme disease.
11. A preponderance of evidence indicates that active ongoing spirochetal infection with or without other tick-borne coinfections is the cause of the persistent symptoms in chronic Lyme disease.
12. There has never been a study demonstrating that 30 days of antibiotic treatment cures chronic Lyme disease. However there is a plethora of documentation in the US and European medical literature demonstrating by histology and culture techniques that short courses of antibiotic treatment fail to eradicate the Lyme spirochete. Short treatment courses have resulted in upwards of a 40% relapse rate, especially if treatment is delayed.
13. Most cases of chronic Lyme disease require an extended course of antibiotic therapy to achieve symptomatic relief. The return of symptoms and evidence of the continued presence of Borrelia burgdorferi indicates the need for further treatment. The very real consequences of untreated chronic persistent Lyme infection far outweigh the potential consequences of long-term antibiotic therapy.
14. Many patients with chronic Lyme disease require prolonged treatment until the patient is symptom-free. Relapses occur and retreatment may be required. There are no tests currently available to prove that the organism is eradicated or that the patient with chronic Lyme disease is cured.
15. Like syphilis in the 19th century, Lyme disease has been called the great imitator and should be considered in the differential diagnosis of rheumatologic and neurologic conditions, as well as chronic fatigue syndrome, fibromyalgia, somatization disorder and any difficult-to-diagnose multi-system illness.
Disclaimer: The foregoing information is for educational purposes only. It is not intended to replace or supersede patient care by a healthcare provider. If an individual suspects the presence of a tick-borne illness, that individual should consult a healthcare provider who is familiar with the diagnosis and treatment of tick-borne diseases.
Basic Information about Lyme Disease
by The International Lyme and Associated Diseases Society
1. Lyme disease is transmitted by the bite of a tick, and the disease is prevalent across the United States and throughout the world. Ticks know no borders and respect no boundaries. A patient's county of residence does not accurately reflect his or her Lyme disease risk because people travel, pets travel, and ticks travel. This creates a dynamic situation with many opportunities for exposure to Lyme disease for each individual.
2. Lyme disease is a clinical diagnosis. The disease is caused by a spiral-shaped bacteria (spirochete) called Borrelia burgdorferi. The Lyme spirochete can cause infection of multiple organs and produce a wide range of symptoms. Case reports in the medical literature document the protean manifestations of Lyme disease, and familiarity with its varied presentations is key to recognizing disseminated disease.
3. Fewer than 50% of patients with Lyme disease recall a tick bite. In some studies this number is as low as 15% in culture-proven infection with the Lyme spirochete.
4. Fewer than 50% of patients with Lyme disease recall any rash. Although the erythema migrans (EM) or “bull’s-eye” rash is considered classic, it is not the most common dermatologic manifestation of early-localized Lyme infection. Atypical forms of this rash are seen far more commonly. It is important to know that the EM rash is pathognomonic of Lyme disease and requires no further verification prior to starting an appropriate course of antibiotic therapy.
5. The Centers for Disease Control and Prevention (CDC) surveillance criteria for Lyme disease were devised to track a narrow band of cases for epidemiologic purposes. As stated on the CDC website, the surveillance criteria were never intended to be used as diagnostic criteria, nor were they meant to define the entire scope of Lyme disease.
6. The ELISA screening test is unreliable. The test misses 35% of culture proven Lyme disease (only 65% sensitivity) and is unacceptable as the first step of a two-step screening protocol. By definition, a screening test should have at least 95% sensitivity.
7. Of patients with acute culture-proven Lyme disease, 20–30% remain seronegative on serial Western Blot sampling. Antibody titers also appear to decline over time; thus while the Western Blot may remain positive for months, it may not always be sensitive enough to detect chronic infection with the Lyme spirochete. For “epidemiological purposes” the CDC eliminated from the Western Blot analysis the reading of bands 31 and 34. These bands are so specific to Borrelia burgdorferi that they were chosen for vaccine development. Since a vaccine for Lyme disease is currently unavailable, however, a positive 31 or 34 band is highly indicative of Borrelia burgdorferi exposure. Yet these bands are not reported in commercial Lyme tests.
8. When used as part of a diagnostic evaluation for Lyme disease, the Western Blot should be performed by a laboratory that reads and reports all of the bands related to Borrelia burgdorferi. Laboratories that use FDA approved kits (for instance, the Mardx Marblot®) are restricted from reporting all of the bands, as they must abide by the rules of the manufacturer. These rules are set up in accordance with the CDCs surveillance criteria and increase the risk of false-negative results. The commercial kits may be useful for surveillance purposes, but they offer too little information to be useful in patient management.
9. There are 5 subspecies of Borrelia burgdorferi, over 100 strains in the US, and 300 strains worldwide. This diversity is thought to contribute to the antigenic variability of the spirochete and its ability to evade the immune system and antibiotic therapy, leading to chronic infection.
10. Testing for Babesia, Anaplasma, Ehrlichia and Bartonella (other tick-transmitted organisms) should be performed. The presence of co-infection with these organisms points to probable infection with the Lyme spirochete as well. If these coinfections are left untreated, their continued presence increases morbidity and prevents successful treatment of Lyme disease.
11. A preponderance of evidence indicates that active ongoing spirochetal infection with or without other tick-borne coinfections is the cause of the persistent symptoms in chronic Lyme disease.
12. There has never been a study demonstrating that 30 days of antibiotic treatment cures chronic Lyme disease. However there is a plethora of documentation in the US and European medical literature demonstrating by histology and culture techniques that short courses of antibiotic treatment fail to eradicate the Lyme spirochete. Short treatment courses have resulted in upwards of a 40% relapse rate, especially if treatment is delayed.
13. Most cases of chronic Lyme disease require an extended course of antibiotic therapy to achieve symptomatic relief. The return of symptoms and evidence of the continued presence of Borrelia burgdorferi indicates the need for further treatment. The very real consequences of untreated chronic persistent Lyme infection far outweigh the potential consequences of long-term antibiotic therapy.
14. Many patients with chronic Lyme disease require prolonged treatment until the patient is symptom-free. Relapses occur and retreatment may be required. There are no tests currently available to prove that the organism is eradicated or that the patient with chronic Lyme disease is cured.
15. Like syphilis in the 19th century, Lyme disease has been called the great imitator and should be considered in the differential diagnosis of rheumatologic and neurologic conditions, as well as chronic fatigue syndrome, fibromyalgia, somatization disorder and any difficult-to-diagnose multi-system illness.
Disclaimer: The foregoing information is for educational purposes only. It is not intended to replace or supersede patient care by a healthcare provider. If an individual suspects the presence of a tick-borne illness, that individual should consult a healthcare provider who is familiar with the diagnosis and treatment of tick-borne diseases.
Monday, May 24, 2010
Adrenal Support Formula
Adrenal Support Formula with 14 researched nutrients
Our product developers were assigned the task of developing the most advanced adrenal support product based on published research. After a thorough review of the literature, they formulated Energy Multi-Plex™ --- the total energy formula. A favorite among doctors and patients, Energy Multi-Plex™ is a reasonably priced answer to many people's dreams of more energy.
“I have improved energy after supplementing with NT Factor Energy and Energy Multi-Plex. Especially notable are the increased maximal sudden power, endurance, and ability to recover during exercise and also for the next day events - for example in distance bicycling on hilly roads and weight lifting and aerobic exercising at the Y. These two Researched Nutritionals products were added to a thorough treatment program for a longer-term fatigue illness from tick borne infection complex illness in the later, more recent stages of therapy. I think the products address some of what we know about mitochondrial damage in the longer-term fatigue- like syndromes and look forward to discussing this further with others interested in increased energy. I have no conflicts of interest in my dialogues regarding Researched Nutritionals products.” --- H. Smith MD
Each bottle provides a one month supply of the following complexes and health benefits:
Energymax™ Complex: Targeted blend of D-ribose, panax ginseng which
• promotes healthy energy levels by raising the level of the body’s energy fuel, ATP
• supports healthy cognitive performance
MuscularEnergy™ Complex: Combination of malic acid and rhodiola rosea which
• plays a key role in energy producing Kreb’s Cycle
• has an adaptogenic affect to support physical activity
Mitrochondria Energizer™ Complex: Powerful duo of acetyl-L-carnitine and alpha lipoic acid which
• acts as a catalyst for ATP production in mitochondria
• improves mitochondrial function while promoting healthy cognitive function
Metabolism Plus™ Complex: Natural, non-stimulation blend of pyruvic acid and 7-Keto DHEA which
• naturally increases, without artificial stimulation, resting metabolism
• multiple studies show increased fat utilization (fat loss) as an energy source
• promotes fat loss through thermogenesis
HeartStrong™ Complex: Hight potency Co Q10 and L-Taurine which
• is used by the body to transform food into adenosine triphosphate (ATP), the energy on which the body runs
• promotes healthy heart and gum tissue
• modulates the immune system
• promotes healthy heart beat and cell wall stability
Key Nutrient Blend: pantothenic acid, vitamin B-12, magnesium and potassium which
• are essential nutrients involved in producing, transporting and releasing energy from fat
• promotes healthy neuromuscular function and muscle contractions
Suggested Use
As a dietary supplement, take three capsules per day (at one time or throughout the day) or as directed by your healthcare professional.
Buy Researched Nutritionals
Our product developers were assigned the task of developing the most advanced adrenal support product based on published research. After a thorough review of the literature, they formulated Energy Multi-Plex™ --- the total energy formula. A favorite among doctors and patients, Energy Multi-Plex™ is a reasonably priced answer to many people's dreams of more energy.
“I have improved energy after supplementing with NT Factor Energy and Energy Multi-Plex. Especially notable are the increased maximal sudden power, endurance, and ability to recover during exercise and also for the next day events - for example in distance bicycling on hilly roads and weight lifting and aerobic exercising at the Y. These two Researched Nutritionals products were added to a thorough treatment program for a longer-term fatigue illness from tick borne infection complex illness in the later, more recent stages of therapy. I think the products address some of what we know about mitochondrial damage in the longer-term fatigue- like syndromes and look forward to discussing this further with others interested in increased energy. I have no conflicts of interest in my dialogues regarding Researched Nutritionals products.” --- H. Smith MD
Each bottle provides a one month supply of the following complexes and health benefits:
Energymax™ Complex: Targeted blend of D-ribose, panax ginseng which
• promotes healthy energy levels by raising the level of the body’s energy fuel, ATP
• supports healthy cognitive performance
MuscularEnergy™ Complex: Combination of malic acid and rhodiola rosea which
• plays a key role in energy producing Kreb’s Cycle
• has an adaptogenic affect to support physical activity
Mitrochondria Energizer™ Complex: Powerful duo of acetyl-L-carnitine and alpha lipoic acid which
• acts as a catalyst for ATP production in mitochondria
• improves mitochondrial function while promoting healthy cognitive function
Metabolism Plus™ Complex: Natural, non-stimulation blend of pyruvic acid and 7-Keto DHEA which
• naturally increases, without artificial stimulation, resting metabolism
• multiple studies show increased fat utilization (fat loss) as an energy source
• promotes fat loss through thermogenesis
HeartStrong™ Complex: Hight potency Co Q10 and L-Taurine which
• is used by the body to transform food into adenosine triphosphate (ATP), the energy on which the body runs
• promotes healthy heart and gum tissue
• modulates the immune system
• promotes healthy heart beat and cell wall stability
Key Nutrient Blend: pantothenic acid, vitamin B-12, magnesium and potassium which
• are essential nutrients involved in producing, transporting and releasing energy from fat
• promotes healthy neuromuscular function and muscle contractions
Suggested Use
As a dietary supplement, take three capsules per day (at one time or throughout the day) or as directed by your healthcare professional.
Buy Researched Nutritionals
Monday, March 9, 2009
What is the difference between CORvalen and CorvalenM?
What is the difference between CORvalen and CorvalenM? Both products recommend 5 grams per serving, and both have the same number of servings of D-ribose the principal active ingredient. In addition, CorvalenM contains magnesium and malate, both shown to improve muscle metabolism and relaxation.
How do I know which is best for me? As a general rule, CORvalen is recommended for heart patients and athletic applications. CorvalenM is used more for muscle aches, pain, soreness, and stiffness. But there are many exceptions with each. Ask yourself, Does my diet need additional magnesium? Magnesium is important for over 200 chemical reactions in the body. Some say the American diet contains less and less natural magnesium because more of our food is processed and we drink more bottled water and beverages than a couple of generations ago.
Conversely, too much magnesium leads to loose stools and diarrhea. You can pick up magnesium from several sources vitamin pills and other supplements.
What are the ingredients for each product? CORvalen is 100% D-ribose. Each serving contains 5g of D-ribose. CORvalen M contains D-ribose, malate and magnesium. For each serving of CORvalen M, there is 5g D-ribose, 240mg Malate (or malic acid) and 800mg magnesium gluconate (the same as 40mg elemental magnesium). CORvalen Chewable Wafers each contain 1.67 grams D-ribose. Other ingredients include inulin, cocoa bean powder, mannitol, modified cellulose, safflower oil, coconut powder, stearic acid, silicon dioxide and natural flavors.
What is ribose? D-Ribose is a simple, 5-carbon monosaccharide, or pentose sugar. It is used by all the cells of the body and is an essential compound in energy metabolism. Ribose is also the carbohydrate backbone of genetic material, DNA and RNA, certain vitamins and other important cellular compounds.
Who needs CORvalen? Ribose is an essential ingredient in stimulating natural energy production. Research has shown that ribose promotes cardiovascular health, reduces cardiac stress associated with strenuous activity and helps athletes extend their exercise tolerance and accelerates recovery. Ribose helps hearts and muscles maximize energy recovery. Whether you are a trained athlete, a weekend warrior or are concerned about your cardiovascular health, ribose may help give the energy boost your body needs.
How is ribose made in the body? Most compounds necessary for life are made in the body through a series of complicated pathways. Ribose is no different. In the body, ribose is made from glucose (a simple 6-carbon sugar) through a pathway called the Pentose Phosphate Pathway (PPP). Eventually, adenosine triphosphate (ATP) is produced. ATP is the primary energy molecule in your body’s cells. Though your body makes ribose and ATP naturally, it produces it slowly. As a result, your heart and muscle tissues use their energy faster than they can restore it and the energy pools become depleted.
How does the body derive cellular energy from ribose? The physiologically functional form of ribose, called 5-phosphoribosyl-1-pyrophosphate (PRPP), regulates the metabolic pathway that synthesizes energy compounds in all living tissue. If this compound is not available in sufficient quantity, energy synthesis slows.
How does taking supplemental CORvalen aid in increasing cellular energy? If the cellular energy pool is depleted by disease or exercise, it must be replaced. PRPP is required to turn on the metabolic pathway used by the body to replenish these energy pools. Supplemental ribose bypasses the slow and rate-limiting enzymes in the Pentose Phosphate Pathway, forms PRPP, and quickly begins the process of energy synthesis.
What will CORvalen do for someone concerned about cardiovascular health? Numerous medical studies have shown that energy levels in the heart can be dramatically lowered by exercise or decreased blood flow associated with certain cardiac diseases. Depleted cardiac energy pools may be associated with increased cardiac stress, altered cardiac function, fatigue and decreased exercise tolerance. Ribose is the key nutrient for quickly restoring cardiac energy stores.
What is the recommended daily dosage of CORvalen? Usual dosage: 5g serving twice daily, taken with meals. A third serving may be added with a midday meal as needed.
Alternative dosage: 5g just before and just after exercise or physical activity.
Serving measurement: 5g of CORvalen powder is a rounded teaspoonful. A single dose measuring scoop is provided with each jar.
CORvalen may be dissolved in 2 oz. or more of juice, tea, or coffee or sprinkled over foods of choice (such as hot oatmeal, yogurt, cold cereal). CorvalenM has a more citrus flavor so it is best in juice, water or yogurt. CORvalen and CorvalenM should NOT be mixed into carbonated beverages.
To maximize athletic performance, or to keep energy pools high during strenuous activity, slightly larger doses may be required. CORvalen (D-ribose) should be taken just before and just after exercise or activity. For extended exercise, an additional 1 to 2 grams per hour of exercise or activity may be helpful.
When can I expect to feel results/benefits from taking CORvalen? Individual response varies widely, but relief from fatigue is often felt within the first 10 days of consistent use.
What can I mix with CORvalen? CORvalen may be mixed with water, juice, coffee, tea or sprinkled on cereal or fruit. It has a mild pleasant sweet taste and is very flexible.
Are there any side effects associated with taking ribose? CORvalen may lower blood sugar for 60 to 90 minutes after ingestion. This may cause one to feel very hungry or lightheaded. This can be avoided by taking with meals or with some form of a carbohydrate such as a juice.
What will ribose do for someone who exercises on a regular basis? Scientific research shows that three or four workouts per week may not allow enough rest time between sessions for heart and muscle energy pools to return to normal levels. Taking CORvalen (D-ribose) shortens the time needed by heart and muscle tissue to replace energy that is lost through vigorous exercise. Keeping energy pools full helps to keep hearts and muscles in good physiological condition, increase power and endurance, and reduce fatigue. Recent research has also shown that ribose supplementation during exercise manages free radical formation and lowers cardiac stress associated with hypoxia.
Does CORvalen conflict with any medications? There are no known interactions with drugs or other supplements.
Does ribose work with creatine or other supplements? Ribose can increase the effect of creatine and other energy supplements by keeping the energy pool at full capacity. Creatine works by recycling energy that is already present in the tissue. Another supplement, carnitine, aids in fatty acid metabolism. A third, pyruvate, also helps to recycle energy. Only ribose performs this important metabolic function. Without adequate levels of energy to work with, no other supplement can be fully effective.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
How do I know which is best for me? As a general rule, CORvalen is recommended for heart patients and athletic applications. CorvalenM is used more for muscle aches, pain, soreness, and stiffness. But there are many exceptions with each. Ask yourself, Does my diet need additional magnesium? Magnesium is important for over 200 chemical reactions in the body. Some say the American diet contains less and less natural magnesium because more of our food is processed and we drink more bottled water and beverages than a couple of generations ago.
Conversely, too much magnesium leads to loose stools and diarrhea. You can pick up magnesium from several sources vitamin pills and other supplements.
What are the ingredients for each product? CORvalen is 100% D-ribose. Each serving contains 5g of D-ribose. CORvalen M contains D-ribose, malate and magnesium. For each serving of CORvalen M, there is 5g D-ribose, 240mg Malate (or malic acid) and 800mg magnesium gluconate (the same as 40mg elemental magnesium). CORvalen Chewable Wafers each contain 1.67 grams D-ribose. Other ingredients include inulin, cocoa bean powder, mannitol, modified cellulose, safflower oil, coconut powder, stearic acid, silicon dioxide and natural flavors.
What is ribose? D-Ribose is a simple, 5-carbon monosaccharide, or pentose sugar. It is used by all the cells of the body and is an essential compound in energy metabolism. Ribose is also the carbohydrate backbone of genetic material, DNA and RNA, certain vitamins and other important cellular compounds.
Who needs CORvalen? Ribose is an essential ingredient in stimulating natural energy production. Research has shown that ribose promotes cardiovascular health, reduces cardiac stress associated with strenuous activity and helps athletes extend their exercise tolerance and accelerates recovery. Ribose helps hearts and muscles maximize energy recovery. Whether you are a trained athlete, a weekend warrior or are concerned about your cardiovascular health, ribose may help give the energy boost your body needs.
How is ribose made in the body? Most compounds necessary for life are made in the body through a series of complicated pathways. Ribose is no different. In the body, ribose is made from glucose (a simple 6-carbon sugar) through a pathway called the Pentose Phosphate Pathway (PPP). Eventually, adenosine triphosphate (ATP) is produced. ATP is the primary energy molecule in your body’s cells. Though your body makes ribose and ATP naturally, it produces it slowly. As a result, your heart and muscle tissues use their energy faster than they can restore it and the energy pools become depleted.
How does the body derive cellular energy from ribose? The physiologically functional form of ribose, called 5-phosphoribosyl-1-pyrophosphate (PRPP), regulates the metabolic pathway that synthesizes energy compounds in all living tissue. If this compound is not available in sufficient quantity, energy synthesis slows.
How does taking supplemental CORvalen aid in increasing cellular energy? If the cellular energy pool is depleted by disease or exercise, it must be replaced. PRPP is required to turn on the metabolic pathway used by the body to replenish these energy pools. Supplemental ribose bypasses the slow and rate-limiting enzymes in the Pentose Phosphate Pathway, forms PRPP, and quickly begins the process of energy synthesis.
What will CORvalen do for someone concerned about cardiovascular health? Numerous medical studies have shown that energy levels in the heart can be dramatically lowered by exercise or decreased blood flow associated with certain cardiac diseases. Depleted cardiac energy pools may be associated with increased cardiac stress, altered cardiac function, fatigue and decreased exercise tolerance. Ribose is the key nutrient for quickly restoring cardiac energy stores.
What is the recommended daily dosage of CORvalen? Usual dosage: 5g serving twice daily, taken with meals. A third serving may be added with a midday meal as needed.
Alternative dosage: 5g just before and just after exercise or physical activity.
Serving measurement: 5g of CORvalen powder is a rounded teaspoonful. A single dose measuring scoop is provided with each jar.
CORvalen may be dissolved in 2 oz. or more of juice, tea, or coffee or sprinkled over foods of choice (such as hot oatmeal, yogurt, cold cereal). CorvalenM has a more citrus flavor so it is best in juice, water or yogurt. CORvalen and CorvalenM should NOT be mixed into carbonated beverages.
To maximize athletic performance, or to keep energy pools high during strenuous activity, slightly larger doses may be required. CORvalen (D-ribose) should be taken just before and just after exercise or activity. For extended exercise, an additional 1 to 2 grams per hour of exercise or activity may be helpful.
When can I expect to feel results/benefits from taking CORvalen? Individual response varies widely, but relief from fatigue is often felt within the first 10 days of consistent use.
What can I mix with CORvalen? CORvalen may be mixed with water, juice, coffee, tea or sprinkled on cereal or fruit. It has a mild pleasant sweet taste and is very flexible.
Are there any side effects associated with taking ribose? CORvalen may lower blood sugar for 60 to 90 minutes after ingestion. This may cause one to feel very hungry or lightheaded. This can be avoided by taking with meals or with some form of a carbohydrate such as a juice.
What will ribose do for someone who exercises on a regular basis? Scientific research shows that three or four workouts per week may not allow enough rest time between sessions for heart and muscle energy pools to return to normal levels. Taking CORvalen (D-ribose) shortens the time needed by heart and muscle tissue to replace energy that is lost through vigorous exercise. Keeping energy pools full helps to keep hearts and muscles in good physiological condition, increase power and endurance, and reduce fatigue. Recent research has also shown that ribose supplementation during exercise manages free radical formation and lowers cardiac stress associated with hypoxia.
Does CORvalen conflict with any medications? There are no known interactions with drugs or other supplements.
Does ribose work with creatine or other supplements? Ribose can increase the effect of creatine and other energy supplements by keeping the energy pool at full capacity. Creatine works by recycling energy that is already present in the tissue. Another supplement, carnitine, aids in fatty acid metabolism. A third, pyruvate, also helps to recycle energy. Only ribose performs this important metabolic function. Without adequate levels of energy to work with, no other supplement can be fully effective.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Saturday, December 6, 2008
NUTRITIONAL SUPPORT IN A PATIENT WITH CHRONIC FATIGUE SYNDROME
NUTRITIONAL SUPPORT USING ULTRACLEAR PLUS ® AND ULTRACLEAR SUSTAIN®
IN A PATIENT WITH CHRONIC FATIGUE SYNDROME
Purpose: To show how a targeted nutritional support program featuring UltraClear PLUS medical food for detoxification and UltraClear SUSTAIN medical food for gastrointestinal (GI)
support may be useful in some patients with long-standing chronic fatigue syndrome (CFS).
Patient’s Presentation and History: A 42-year-old Caucasian female presented with CFS,
reporting unremitting fatigue, insomnia, chronic arthralgias and myalgias, post-exertion exhaustion, cognitive dysfunction, cyclical acne, recurrent sinus and strep infections, and
increasing sensitivity to environmental stimuli (e.g., tobacco smoke, perfumes, newsprint). At the time of presentation, she was on disability and unable to work. The patient primarily ate
organic foods, and noted some bloating with wheat and dairy. She had a history of hypothyroidism, mononucleosis, allergies, migraines, 6 weeks of “colitis -like” symptoms after
pesticide exposure, and multiple antibiotic courses.
Patient’s Objective Information
· BMI†: 22.8; BP: 120/80
· MSQ* score 129
· Results of HEENT exam: notable allergic shiners, lungs lear to auscultation
· Thyroid palpable, liver non-tender, abdomen soft with diffuse tenderness in right and left upper quadrants
· Along with dry skin, reddened vesicles in various stages of eruption, healing, and scarring noted on anterior arms, forearms, calves, and thighs
· Prescriptive medications and supplements included spironolactone (75 mg/day), desiccated thyroid (120 mg/day), and a variety of nutritional supplements
· Assessment: CFS, multiple chemical sensitivities, possible food allergies, and adrenal fatigue
Plan: In addition to continuing prescriptive medications and discontinuing supplements, the patient was instructed to begin taking:
· UltraClear PLUS medical food, 3 servings daily
· Licorice root extract, ¼ tsp qd
· Extract of 7 mushrooms, 30 drops bid
· Multivitamin/mineral supplement without iron, 2 tablets bid
1 and 3 Week Results
The patient’s laboratory results from week 1 showed altered intestinal permeability and detoxification. After 3 weeks on the program, the patient reported improvements in sleep, cognition, and energy and was instructed to:
· Continue UltraClear PLUS, licorice root, multivitamin/mineral supplement without iron
· Discontinue mushroom extract
· Add elimination diet, fiber supplement (1 scoop tid), glutamine (5 grams tid)
8 and 12 Week Results
The patient’s fatigue, energy, and sleep continued to improve. Prior to the program, she was sleeping 14-16 hr/day, decreasing to 8-10 hr/day after 8 weeks on the program. She was instructed to continue the protocol and add sodium sulfate (20 mg bid) to help manage chemical sensitivities. The patient indicated a 30% to 40% improvement overall after 12 weeks, and said she was better able to withstand chemical exposures. Intestinal permeability and detoxification laboratory values also improved. The patient was instructed to add a supplement to support mitochondrial energy production (2 capsules tid).
20 and 32 Week Results
The patient continued to do well and rated her overall improvement at 50% by the 20th week. She was instructed to:
· Continue the elimination diet, licorice root extract, multivitamin/mineral supplement, and fiber supplement
· Discontinue UltraClear PLUS, mitochondrial support supplement, and glutamine
· Begin taking UltraClear SUSTAIN medical food, 2 scoops bid
· Increase sodium sulfate, 400 mg bid
· Add N-acetylcysteine, 500 mg tid
After 32 weeks, the patient was no longer bedridden and continued to show improvement. She decided to remove mercury amalgams and had two chelation IV therapies. The patient noted that support for detoxification, particularly the sodium sulfate, helped her manage chemical sensitivities.
Conclusion
This case study suggests that a focused nutritional program featuring UltraClear PLUS for detoxification and UltraClear SUSTAIN to support healthy GI function may help address
CFS symptoms—including multiple chemical sensitivities associated with long-term CFS.
CASE STUDY #909
Figure 1
After 32 weeks, the patient’s Medical Symptoms Questionnaire* score decreased from 129 to 18 (reference range: <30>RESULTS
strong86% Improvement in MSQ Score
129
18
0
50
100
150
Before Program After 32 Weeks
MSQ Score 91% Reduction in Intestinal Permeability ("Leaky Gut")
0.338
0.031
0
0.1
0.2
0.3
0.4
Initial Lab Results After 32 Weeks
Lactulose-Mannitol Ratio
2X the Total
Acetaminophen Recovery
40.60%
83.20%
0.00%
20.00%
40.00%
60.00%
80.00%
100.00%
Initial Lab Results
After 32 Weeks
AIMS2: Physical Score
†BMI is the Body Mass Index and can be computed by the weight (kg) divided by the square of the height (m).
*The Medical Symptoms Questionnaire (MSQ) is a clinical tool for the evaluation of general physical symptoms. Total scores above 75 are generally associated with substantial symptomatology and disability; scores below 30 generally indicate few or low intensity symptoms.
© Metagenics, Inc. MET909 4/04
Note: The information provided in this case study describes the results of one patient under the care of a licensed healthcare practitioner and may not be a typical response. UltraClear PLUS medical food and UltraClear SUSTAIN medical food are to be used under the supervision of a physician or other licensed healthcare practitioner.
Case Study: Nutritional Support Using UltraClear PLUS and UltraClear SUSTAIN in a Patient with Chronic Fatigue Syndrome. Metagenics, Inc.; 016CFS1203.
IN A PATIENT WITH CHRONIC FATIGUE SYNDROME
Purpose: To show how a targeted nutritional support program featuring UltraClear PLUS medical food for detoxification and UltraClear SUSTAIN medical food for gastrointestinal (GI)
support may be useful in some patients with long-standing chronic fatigue syndrome (CFS).
Patient’s Presentation and History: A 42-year-old Caucasian female presented with CFS,
reporting unremitting fatigue, insomnia, chronic arthralgias and myalgias, post-exertion exhaustion, cognitive dysfunction, cyclical acne, recurrent sinus and strep infections, and
increasing sensitivity to environmental stimuli (e.g., tobacco smoke, perfumes, newsprint). At the time of presentation, she was on disability and unable to work. The patient primarily ate
organic foods, and noted some bloating with wheat and dairy. She had a history of hypothyroidism, mononucleosis, allergies, migraines, 6 weeks of “colitis -like” symptoms after
pesticide exposure, and multiple antibiotic courses.
Patient’s Objective Information
· BMI†: 22.8; BP: 120/80
· MSQ* score 129
· Results of HEENT exam: notable allergic shiners, lungs lear to auscultation
· Thyroid palpable, liver non-tender, abdomen soft with diffuse tenderness in right and left upper quadrants
· Along with dry skin, reddened vesicles in various stages of eruption, healing, and scarring noted on anterior arms, forearms, calves, and thighs
· Prescriptive medications and supplements included spironolactone (75 mg/day), desiccated thyroid (120 mg/day), and a variety of nutritional supplements
· Assessment: CFS, multiple chemical sensitivities, possible food allergies, and adrenal fatigue
Plan: In addition to continuing prescriptive medications and discontinuing supplements, the patient was instructed to begin taking:
· UltraClear PLUS medical food, 3 servings daily
· Licorice root extract, ¼ tsp qd
· Extract of 7 mushrooms, 30 drops bid
· Multivitamin/mineral supplement without iron, 2 tablets bid
1 and 3 Week Results
The patient’s laboratory results from week 1 showed altered intestinal permeability and detoxification. After 3 weeks on the program, the patient reported improvements in sleep, cognition, and energy and was instructed to:
· Continue UltraClear PLUS, licorice root, multivitamin/mineral supplement without iron
· Discontinue mushroom extract
· Add elimination diet, fiber supplement (1 scoop tid), glutamine (5 grams tid)
8 and 12 Week Results
The patient’s fatigue, energy, and sleep continued to improve. Prior to the program, she was sleeping 14-16 hr/day, decreasing to 8-10 hr/day after 8 weeks on the program. She was instructed to continue the protocol and add sodium sulfate (20 mg bid) to help manage chemical sensitivities. The patient indicated a 30% to 40% improvement overall after 12 weeks, and said she was better able to withstand chemical exposures. Intestinal permeability and detoxification laboratory values also improved. The patient was instructed to add a supplement to support mitochondrial energy production (2 capsules tid).
20 and 32 Week Results
The patient continued to do well and rated her overall improvement at 50% by the 20th week. She was instructed to:
· Continue the elimination diet, licorice root extract, multivitamin/mineral supplement, and fiber supplement
· Discontinue UltraClear PLUS, mitochondrial support supplement, and glutamine
· Begin taking UltraClear SUSTAIN medical food, 2 scoops bid
· Increase sodium sulfate, 400 mg bid
· Add N-acetylcysteine, 500 mg tid
After 32 weeks, the patient was no longer bedridden and continued to show improvement. She decided to remove mercury amalgams and had two chelation IV therapies. The patient noted that support for detoxification, particularly the sodium sulfate, helped her manage chemical sensitivities.
Conclusion
This case study suggests that a focused nutritional program featuring UltraClear PLUS for detoxification and UltraClear SUSTAIN to support healthy GI function may help address
CFS symptoms—including multiple chemical sensitivities associated with long-term CFS.
CASE STUDY #909
Figure 1
After 32 weeks, the patient’s Medical Symptoms Questionnaire* score decreased from 129 to 18 (reference range: <30>RESULTS
strong86% Improvement in MSQ Score
129
18
0
50
100
150
Before Program After 32 Weeks
MSQ Score 91% Reduction in Intestinal Permeability ("Leaky Gut")
0.338
0.031
0
0.1
0.2
0.3
0.4
Initial Lab Results After 32 Weeks
Lactulose-Mannitol Ratio
2X the Total
Acetaminophen Recovery
40.60%
83.20%
0.00%
20.00%
40.00%
60.00%
80.00%
100.00%
Initial Lab Results
After 32 Weeks
AIMS2: Physical Score
†BMI is the Body Mass Index and can be computed by the weight (kg) divided by the square of the height (m).
*The Medical Symptoms Questionnaire (MSQ) is a clinical tool for the evaluation of general physical symptoms. Total scores above 75 are generally associated with substantial symptomatology and disability; scores below 30 generally indicate few or low intensity symptoms.
© Metagenics, Inc. MET909 4/04
Note: The information provided in this case study describes the results of one patient under the care of a licensed healthcare practitioner and may not be a typical response. UltraClear PLUS medical food and UltraClear SUSTAIN medical food are to be used under the supervision of a physician or other licensed healthcare practitioner.
Case Study: Nutritional Support Using UltraClear PLUS and UltraClear SUSTAIN in a Patient with Chronic Fatigue Syndrome. Metagenics, Inc.; 016CFS1203.
Monday, June 2, 2008
D-Ribose—A Very Powerful and Natural Body Energizer
D-Ribose—A Very Powerful and Natural Body Energizer
Buy D-Ribose Corvalen CorvalenM at guaranteed best prices
(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.
Buy D-Ribose Corvalen CorvalenM at guaranteed best prices
(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.
Sunday, June 1, 2008
The Use of D-Ribose in Chronic Fatigue Syndrome
Buy CorvalenM, Corvalen D-Ribose Lowest/Best Price
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.
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Address reprint requests to:
Jacob E. Teitelbaum, M.D.
76-6326 Kaheiau Street
Kailua-Kona, HI 96740
E-mail: Endfatigue@aol.com
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