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Restoring Cellular Energy Metabolism

October 2012

By Kirk Stokel


Fibromyalgia (FM) and chronic fatigue syndrome are conditions that often occur together and are believed to have a similar underlying cause.28

There's accumulating evidence that defective production of ATP is the culprit.28-30 These findings make d-ribose a natural candidate as a therapy for those suffering from fibromyalgia and chronic fatigue syndrome. A published case study showed that a woman with fibromyalgia experienced a decrease in symptoms following supplementation with d-ribose.31 The patient had been unresponsive to prior medications, and her physicians based their decision on the known energy-enhancing capabilities of d-ribose.

A larger study soon followed enlisting 41 patients with fibromyalgia or chronic fatigue syndrome.28 Subjects took 5 grams of d-ribose three times daily until they reached a total of 280 grams.

There was significant improvement in all five categories on a standard score: energy, sleep, mental clarity, pain intensity, and well-being.28 On average, patients reported a 45% increase in energy levels.

While fibromyalgia and chronic fatigue syndrome remain complicated and perplexing to scientists, these findings offer real hope for a solution.

Restless Leg Syndrome

Restless Leg Syndrome

Restless leg syndrome (RLS) is a common disorder that affects as many as 15% of the US population, and it is severe enough to warrant medical treatment in more than a third of those people.32,33

The condition involves an uncontrollable urge to move the legs, accompanied by uncomfortable sensations, and it is usually worse at night.33 Only a few medications offer even partial relief of restless leg syndrome, and many make the condition worse—leaving sufferers without much recourse.32,33

Disordered energy metabolism has been suggested as one possible cause of restless leg syndrome. Low levels of adenosine, the d-ribose-containing central molecule in ATP, have been reported in those suffering from restless leg syndrome.34

Based on that observation, one study has been carried out in which daytime symptoms were eliminated, and nighttime symptoms significantly reduced, on daily doses of 15 grams of d-ribose, taken as one 5-gram dose with breakfast, lunch, and dinner.26

It's clearly too early to claim that d-ribose cures the condition, but these encouraging findings—coupled with complete absence of side effects—warrant further investigation.

Ungrounded Fear: Can D-Ribose Cause Glycation Reactions?

It is now generally accepted that d-ribose supplementation provides many health benefits, particularly in the area of cellular energy management.

Several recent publications, however, have raised the question of whether d-ribose—because it is a sugar—could possibly contribute to development of harmful advanced glycation endproducts.40-43

The truth seems to be straightforward: Like any sugar, ribose can indeed cause protein glycation, with resulting damage to tissues.42 And when ribose is administered experimentally at the same high dose as glucose, ribose quickly causes the protein cross-linking that is the outcome of glycation.40

But those studies used artificially high doses and concentrations of ribose, levels never found in humans—even after high-dose supplementation.

For example, in a human study of d-ribose supplementation at doses of 20 and 53 grams over a 4-hour period, peak serum ribose levels rose to only 4.8 mg/dL and 81.7 mg/dL, respectively.44

But doses used in the glycation experiments were significantly higher, up to 30 times higher than achievable in human blood!42,43

And in an experiment showing that d-ribose induced glycation and impaired spatial cognition in mice, the ribose concentrations used were equivalent to blood levels of 150 to 750 mg/dL, clearly vastly higher than have been used in human studies.43,44

Researchers seeking to show that ribose-induced glycation could enhance cartilage damage in an animal model of osteoarthritis showed conclusively that even direct injection of ribose into the joint was incapable of triggering sufficient glycation to cause injury!45,46

The doses for d-ribose studies reported in this article—15 to 60 grams per day in divided doses—are incapable of causing serum ribose concentrations high enough to get anywhere near the risk of excessive glycation reported in the lab studies.44

Also, most human studies recommended splitting the total amount into three daily doses; this approach provides even greater assurance that serum d-ribose remains well within safe levels.

Kidney Protection

Like the brain and heart, the human kidney receives a a high proportion of the body's total blood flow—which makes it equally vulnerable to damage by ischemia-reperfusion mechanisms, the loss and restoration of blood flow.

These kidney injuries can occur as the result of trauma or during any major surgery, sometimes worsened by chronic conditions such as cardiovascular disease and diabetes.35-37

Growing evidence suggests that an immune activation and inflammatory response following this kind of kidney injury creates the bulk of the damage, especially in those with diabetes.12,38 Adenosine, which is partly made from d-ribose, is an important regulator of kidney function, and is especially vital during times of injury.39 These observations—coupled with what we know about d-ribose as antioxidant and anti-inflammatory—have aroused considerable interest among kidney researchers.

Japanese scientists have led the way in investigating d-ribose as a kidney protector. They have found that in rats subjected to renal ischemia-reperfusion—similar to what can occur during major surgery—d-ribose significantly reduced the release of inflammatory cytokines.12 Kidney function and appearance following the injury was improved substantially.

They also showed that d-ribose reduces activation of neutrophils, the ubiquitous white blood cells that are the first to arrive at the scene of an injury but that also release toxic chemicals and oxygen radicals that can cause additional harm.11

Clearly researchers are only beginning to realize the substantial potential of d-ribose for kidney health.


D-ribose is an essential component in our bodies' cellular energy management systems. Additionally, it provides antioxidant, anti-inflammatory, and gene regulatory capabilities. Together these characteristics make it of compelling interest to forward-thinking clinicians and patients.

Supplemental d-ribose demonstrates cardioprotection—even late in the disease process when heart attacks have already occurred, and when heart failure is developing. D-ribose helps ailing heart muscle maximize its effort, and improves blood flow to oxygen-starved cardiac tissue.

D-ribose supplements are only just being explored for similar benefits in brain and kidney tissues, but recent studies offer great hope in those areas. Even perplexing conditions such as fibromyalgia and restless leg syndrome seem to be yielding to the energy-related benefits of d-ribose. •

If you have any questions on the scientific content of this article, please call a Life Extension® Health Advisor at 1-866-864-3027.