What frustrates many people who suffer from fatigue with or without the associated muscular pain known as fibromyalgia is the fact that, on paper, they are too well to be ill. Routine blood tests are typically normal in both situations but the level of pain and fatigue are far from normal and can be life destroying.
Back in August we posted a brief note on the research behind ribose and fatigue. In this post we take it a bit further and explain more of the detail.
It is true to say that there is no known cause for fibromyalgia with all laboratory tests including muscle samples (biopsies) taken from the most tender regions appearing perfectly normal on specialist examination and analysis. This lack of medical evidence places sufferers in a dilemma; how to manage the problem? Exciting work coming out of America is throwing new light on the issue. The latest in a number of small scale studies confirms what has been observed clinically. A simple sugar-like substance, known as ProRibose (contains pure D-ribose), can be of help. The study in question involved 41 sufferers and was set up to investigate the effects of D ribose on two key end points; improvements in pain relief and easing of fatigue. The average age of the study group was 48 years old and 78% were female. This is in keeping with the typical profile of a fibromyalgia and fatigue sufferer. As with many studies, some people dropped out before the test month was finished but of the 36 who completed the trial 69% reported significant improvements in both of the symptoms being investigated and a 25% improvement in quality of life, as assessed by a special questionnaire. The mechanism behind this exciting set of results is not clear. What is known, however, is that fibromyalgia sufferers have lower levels of the energy molecule called adenosine triphosphate (ATP) and a reduced capacity to make ATP in their muscles. It is also known from previous studies that D-ribose can fuel ATP production. This may, in part, be responsible for the effects of D-ribose supplementation which appears to reduce muscle pain and enhance quality of life for those suffering with fibromyalgia and / or chronic fatigue. D-Ribose, also known simply as ribose, is a simple sugar. Technically known as a 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 also provides the structural backbone of our genetic material, DNA and RNA, certain vitamins and other important cellular compounds. If the cellular energy pool is depleted by disease, overwork, or exercise it must be replaced. Supplemental ribose can be viewed as jump-starting the energy manufacturing mechanisms and accelerating the process of energy production. To date D-ribose has been shown to be a safe supplement. Only two side effects have been noted; in very large doses, in excess of 10 grams, loose stools (diarrhoea) has been reported and in similar doses a transient dip in blood sugar levels. However, when using any supplement that contains or influences the blood sugar levels or energy levels it is always recommended that a diabetic patient consults a health professional beforehand. To reduce both of these potential but rare side effects, sensitive individuals should take D-ribose with a carbohydrate meal. Taking D-ribose at the recommended intake of between 2-5 grams per dose is not normally associated with any dose effects. A great advocate of the use of D-ribose in CFS/FM is Dr Jacob Teitelbaum. He has suggested that its critical to use the proper dose for the first 3 weeks, which is 5 grams (5000 mg) three times a day, after which the intake can be dropped to twice a day. Dr Teitelbaum is keen on using D-ribose in CFS/FM patients because he has noted that when people consume D-ribose, their 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. With its established association with the energy currency of the cell (ATP) D-ribose provides the key building block of ATP, and the presence of D-ribose in the cell stimulates the metabolic pathway our bodies use to actually make this vital compound. If the cell does not have enough D-ribose, it cannot make ATP. So, when cells and tissues become energy starved, the availability of D-ribose is critical to energy recovery. In his detailed article about D-ribose (available online) Dr Teitelbaum describes how normal, healthy heart and muscle tissue has the capacity to make all the D-ribose it needs. However, 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 gardening or similar unaccustomed work. 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 D-ribose quickly enough to recover. Heart and skeletal muscles just don’t have the metabolic machinery they need to make D-ribose very efficiently. The result is chronic, persistent pain, stiffness, soreness, and overwhelming fatigue that may never go away. Given the high level or reported muscular pain in cases of CFS/FM that fit this clinical picture it would appear reasonable to consider a trial of D-ribose following the dose recommendation outlined by Dr Teitelbaum, who as a CFS/FM sufferer himself, takes D-ribose every day. Most natural agents are needed for 4-9 months to help restore deficiencies but if D-ribose works for you its safe to use on a regular basis.
Study supports D-Ribose use
In a very recent study published in the Pain Journal this year, Dr Teitelbaum and colleagues followed 203 diagnosed CFS/FM patients over a 3-weeks course of D-Ribose therapy. They discovered that improvements began in the first week of treatment, and continued to increase at the end of the 3 weeks of treatment. Their findings are summarized below;
61.3 % increase in energy
37% increase in overall well being
29.3% improvement in sleep
30% improvement in mental clarity
15.6% decrease in pain
At the end of the study they concluded that D-ribose resulted in markedly improved energy levels, sleep, mental clarity, pain relief, and well being in patients suffering from fibromyalgia and chronic fatigue syndrome.
Useful product link to ProRibose.