D-Ribose Improves Cardiac Function in Heart Failure PatientsJune 2019
By Julie Stein
When it comes to heart failure, the statistics are chilling.
More than 870,000 new cases are diagnosed in the U.S. each year in people aged 55 and older.1-4
One in five people who are currently 40 years old will go on to develop heart failure in their lifetimes. By 2030 it is expected that more than eight million Americans will be affected by the disease.1-3
Heart failure occurs when the heart fails to pump enough blood to support the whole body.1 It is a debilitating and progressive condition.
Clinical trials have shown that supplementation with D-ribose, which is produced in the body, can improve heart function following damage to the heart muscle.
It helps the heart muscle manage energy, offering a potential solution to the slow-motion cardiac energy crisis that is heart failure.5-7
But how does D-ribose achieve these results?
The answer has to do with the way energy is released and converted into adenosine triphosphate (ATP). This universal “energy currency” then transfers energy to cells in a form they can use to do their cellular work.
Here, we review the compelling clinical studies that reveal the power of D-ribose in heart failure, and then explain precisely how it works to feed the energy-hungry, failing heart.
What you need to know
- Heart failure means the heart muscle is failing to pump enough blood to meet the body’s metabolic requirements.
- Its incidence is rising, but there are no good, long-term medications available that truly treat heart failure and reverse its debilitating effects.
- The field of metabolic cardiology suggests that fundamental energy requirements go unmet in muscle cells of a failing heart, leading to significant drops in ATP, the energy-carrying molecule that supports all cellular work.
- One source of low ATP in heart failure is a diminished supply of the sugar D-ribose, which ailing heart cells cannot manufacture fast enough to meet energy requirements.
- Studies now show that supplemental D-ribose, 5 grams three times daily, can significantly improve heart muscle function in heart failure, resulting in better pumping action and reduced workload on heart and lungs.
D-Ribose Improves Heart Function
D-ribose is a building block of ATP,8 the energy source for every cell. Research has demonstrated that D-ribose supplementation can support the heart’s ability to extract energy and store it in the form of ATP, improving the function of the heart even if it’s been damaged.7
Human studies show the following potential of D-ribose to reduce the symptoms of heart failure when given orally at a dose of 5 grams three times daily:
Improved blood flow through the heart.
Heart failure results in slower flow of blood through the heart, raising the amount of
work the heart muscle must do to push the
blood through the body. Fifteen patients with chronic coronary artery
disease and heart failure were randomly assigned to receive D-ribose or a
placebo for three weeks,
and after a one-week “washout” period, were switched to the opposite
therapy.7 During the D-ribose supplement phases subjects had
significantly enhanced filling of the left ventricle and other signs of reduced cardiac loading that eased the workload on the ailing heart muscle, and significantly improved measures of quality of life. No such changes were seen during placebo phases.
- Improved blood flow in the body. Heart failure reduces the amount of blood the heart can pump with each beat, slowing down the body’s whole circulation, imperiling organs that need ample blood supply. Eleven patients with New York Heart Association Class II-IV (mild to severe) heart failure were supplemented with D-ribose for six weeks.5 At the end of the six-week supplementation period, improved blood flow in tissues was shown by Doppler ultrasound in 64% of patients. This improvement lasted through nine weeks—three weeks after the end of supplementation.
- Improved exchange of oxygen and CO2 through the lungs.
Heart failure increases how hard the heart-lung system must work
to rid the body of carbon dioxide and take in oxygen. Sixteen people with
New York Heart Association Class III-IV heart failure (among the most
severe) were treated in a trial of D-ribose for eight weeks.6
All patients had
a significant improvement in their breathing parameters, which are so often
in heart failure.
D-ribose supplementation significantly increased ventilatory efficiency (how much air needs to be moved to eliminate metabolically- produced carbon dioxide from the body) by 16%. Ventilatory efficiency is a strong predictor of survival in heart failure patients, so this demonstrates a direct reduction in the risk of dying.6 Measures of oxygen uptake efficiency, oxygen flow through the lungs, and amount of oxygen pumped per heartbeat also improved, by 25%, 19%, and 16%, respectively, demonstrating marked increases in the ability of the heart-lung system to take up oxygen and rid the body of carbon dioxide.
Together, these and other studies show the value of adding a D-ribose supplement, 5 grams three times daily, to improve heart failure symptoms and quality of life in heart failure patients.
A deeper look into what happens in the muscles of a failing heart has opened an entirely new chapter in metabolic cardiology, the study of how the heart’s own energy flow affects its pumping capacity.9,10
D-Ribose Supports Cardiac Energy Metabolism
After a hard workout or physical labor, our muscles are tired and weak. That’s because, at the cellular level, they’ve used up much of the available molecules of ATP that provide the energy for the cellular work of moving. We rest after exercise or hard work in order to give our muscles time to burn more glucose to make more ATP.
The same situation occurs in the heart, with one vital difference: The heart muscle can’t stop to rest and re-energize itself with more ATP. When ATP levels fall, the heart muscle simply operates with increasing weakness, pumping less blood with each beat.
If we can figure out a way to boost ATP levels, we can re-energize the heart muscle and may prevent or even reverse the symptoms of heart failure.
To understand how D-ribose benefits the heart, we need to look at the makeup of ATP itself.
The ATP molecule consists of three major parts, as seen in Figure 1 on the next page.
Adenine is a nucleotide, one of the building blocks of DNA.
Adenosine is simply adenine chemically bonded to a molecule of D-ribose.8 D-ribose is a structural component of the vital ATP molecule.9
The D-ribose portion of adenosine binds tightly to a series of phosphate molecules, with each chemical bond between the phosphate groups containing energy extracted from the metabolism of glucose and fat. ATP, with three such bonds, contains more stored energy than adenosine monophosphate (AMP), which has just one.
A maximum of three high-energy phosphate groups can be bound to a single adenosine molecule, producing adenosine triphosphate, or ATP. When cells require energy, they release phosphates from ATP to carry out useful work by harvesting the newly-released energy.8,11
But in heart failure, a cellular energy deficiency arises in which D-ribose production falls in heart muscle cells.12 This leads directly to a decrease in ATP production in the very cells that need energy the most. Without ample D-ribose, cells cannot capture metabolic energy, and almost literally starve themselves into weakness.8
The obvious solution, then, is to provide extra D-ribose in the form of an oral supplement, which bypasses the overwhelmed cellular D-ribose-producing machinery and permits creation of many new ATP molecules.8
And it works. One of the first studies of supplemental D-ribose was done in dogs back in 1989. It showed that ATP levels are depressed by about 50% following loss of blood flow (ischemia) in the heart muscle. But when the dogs were supplemented with D-ribose intravenously, during and after the ischemic event, ATP levels rebounded to 85% of their normal levels within 24 hours, a benefit not seen in the unsupplemented animals.13
In other words, D-ribose replenishes low cardiac muscle energy levels, improving cardiac function during ischemia.6
The evidence for D-ribose as a heart muscle energizer is so great that scientists have proposed treating it as a conditionally essential nutrient. This means that, under certain conditions, like heart failure, D-ribose is so important that its levels must be supported by external supplementation.14
Heart failure is increasing, with an estimated eight million sufferers expected by 2030.
Currently, drugs for heart failure are only marginally effective and act by forcing the heart muscle to work harder, even as it is being deprived of sufficient ATP to perform extra work.
An alternative approach, called metabolic cardiology, offers a more natural and physiologically sound way to improve heart muscle performance. Researchers have found that we can improve the conditions that lead to ATP production within the heart muscle itself by providing D-ribose as a vital “substrate” for ATP production.
Studies in animals, and now in humans, have shown that increasing available D-ribose, the “scaffold” on which ATP is built, can dramatically restore energy to the heart, enabling it to carry out its vital work with greater power and efficiency.
Regular supplementation with D-ribose is one proven means of feeding the starving heart muscle and producing real improvements in cardiovascular function.
If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.
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- St Cyr JA, Bianco RW, Schneider JR, et al. Enhanced high energy phosphate recovery with ribose infusion after global myocardial ischemia in a canine model. J Surg Res. 1989 Feb;46(2):157-62.
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