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Energizing Heart & Muscle Cells with D-Ribose
Posted by Jackie
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Energizing Heart & Muscle Cells with D-Ribose September 24, 2006 09:57AM |
Registered: 7 years ago Posts: 18,886 |
This is another very long post and I apologize in advance; there is so much to include.
I toyed with the idea of titling this Miracle Nutrient or using Dr. Sinatras tag, "D-Ribose, The Sugar of Life The Missing Link.
For over 18 months, Ive been experimenting with ribose supplementation and I wanted to call your attention to this important nutrient not only for cardiac function, but overall muscle function as well. Endurance athletes will be especially interested in the benefits of ribose. Ribose has been proven to accelerate tissue energy recovery and aid in restoring the physiological condition of muscle. That reduces cell damage and protects the heart and muscles from the rigors of strenuous exercise.
When I heard cardiologist Stephen Sinatra speak passionately about the benefits of ribose and his clinical experiences, I was interested but didnt act on the information for a few months. His mention that it was highly beneficial for helping fibromyalgics got my attention. A few months later, because I attended the 2004 Anti Aging Congress, I was sent a complementary copy of his book, The Sinatra Solution. Its all about nutritional support for heart tissue and help for heart conditions. I read about ribose and began my own experiment of one.
Then I heard a nutritional teleconference featuring PhD biochemist, Clarence Johnson, President and CEO of BioEnergy, Inc., the developer of ribose-based products marketed under several names including CorValen. This was my primary motivation to continue experimenting with ribose dosage.
I want to share some of the basic reasons why ribose is important and direct you to resources for your own research if this stimulates your interest. This is my mission part, create awareness.
At the BioEnergy research library, I even found a very relevant portion indicating a link to arrhythmia. That reference is at the very end of this post in the excerpt of the article, Scientific Rationale for the Nutritional Use of D-Ribose to Support Skeletal Muscle Health and Function. Also included at the end is a reference to potassium channels regulated by the intracellular levels of ATP and a potential to produce electrical instability and pro-arrhythmic effect.
First, a bit of background:
BioEnergy holds 26 patents or pending in the US and abroad on ribose products for a variety of uses. The company was founded by a pediatric cardiovascular surgeon in 1986, John Foker, also a PhD biochemist. Dr. Johnson joined him in research and eventually became part of the management. Originally, D-ribose was a very expensive raw material which limited practical, wide-spread use, but a method of making it through a natural fermentation process was developed and it is now more affordable. Ribose metabolism was discovered in 1944 but it wasnt until the mid-80s and with Dr. Fokers work, that it was connected to cardiac function. Not much has been heard about it until the last 3 4 years. Dr. Sinatra is actively promoting its use and now other forward-thinking cardiologists are using it with impressive results.
Its not just the heart muscle that benefits, but also skeletal muscles and post exertional recovery. For heart protection and energy, ribose is invaluable.
When I was listing to Dr. Johnson, I once again had that ah ha moment of enlightenment and I was motivated to pursue the ribose connection and why it would be helpful for my fibromyalgia symptoms and also my heart. I was not disappointed in finding substantial data. This is a functional nutrient that is well researched.
My Experience:
When I began my experiment, I was almost sorry I no longer had afib, but I knew my heart would benefit regardless so I was looking forward to confirming what many studies indicate that ribose enables those with fibromyalgia to be free of pain and fatigue. The results were almost immediate and miraculous. I experimented with doses - stopping and starting again, just to be sure. It was true. The symptoms are diminished by 99%. My fatigue has diminished as well; my energy and stamina have definitely improved.
Additionally, my heart feels solid and strong and the minor bursts of sinus tachycardia have diminished to clinically insignificant in frequency. If I had afib today, Id be taking ribose regularly, along with CoQ10 and maybe L-Carnitine and definitely taking it during an event to avoid that dragged out feeling afterwards.
The literature on ribose is abundant. I wont belabor this into hugely lengthy technical report but I am duplicating some of the data from BioEnergys research to explain why ribose is beneficial to heart cells and why it benefits those who exercise, especially those who train vigorously. References are listed for those wishing to do more research. Im providing highlights; and you can decide what to do with this information. Over 100 scientific publications describe the beneficial effects of ribose in heart and muscles. Bottom Line: Ribose is cutting edge.
Knowledge is power,
Jackie
[Following are excerpts and quotes see references]
What is Ribose?
D-Ribose is a mildly-sweet tasting powder and is a simple 5-carbon monosaccharide used by all living cells as an essential compound in cellular energy metabolism. Ribose, needed to synthesize adenine nucleotides, is the carbohydrate backbone of genetic material - DNA and RNA, certain vitamins, and other important cellular compounds.
Ribose is a carbohydrate (sugar) naturally found in all cells of the body. Physical stress can increase the loss of nucleotides (such as ATP, ADP and AMP) from the hearth and skeletal muscles. Ribose metabolizes into 5-phophoribosyl-1-pyrophosphate (PRPP), which is a rate limiting substance used in the synthesis of nucleotides.
Without ribose, tissues could not produce these life-giving compounds. Adenine nucleotides are required by heart, muscle and other tissue to make adenosine triphosphate (ATP), the primary source of energy used by all cells to maintain normal health and function. When the pool of adenine nucleotides is depressed by disease or strenuous exercise or activity, the level of energy available to the cell is compromised. A reduction in cellular energy level can lead to diminished function and reduced physiological health.
Unfortunately, many tissues, including heart and skeletal muscles, do not have the metabolic machinery to make ribose quickly when it is needed to rebuild energy levels that might be depressed by disease, exercise or strenuous activity. As such, when these tissues come under metabolic stress, they may not be able to adequately maintain energy pools. A reduced capacity for energy maintenance may impact tissue health and normal function. Forming ribose in heart and muscle cells is a slow process. As a result heart and muscle tissues are unable to replace energy pools quickly once they have been depleted by disease or exercise.
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 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 heart and muscles in good physiological condition, increase power and endurance, and reduce fatigue. Recent research has also shown that ribose supplementation during exercise reduces free radical formation and lowers cardiac stress associated with hypoxia.
Dr. Johnson says: In normal healthy hearts that have been stressed with ischemia or hypoxic insult, research shows that it takes more than 10 days to fully recover the energy charge. Thats in a normal healthy heart. In muscle, we know it takes more than 3 days because weve done all the studies to show the ATP recovery rate in skeletal muscle following exercise and we know it to be greater than 3 days.
So, with a chronic case of oxygen deprivation, like in heart disease or what I call chronic exercise when people exercise every day or when high intensity exercise every day or every other day, and the oxygen deprivation is repeated, the tissue simply cant make ribose fast enough to ever recover. [note emphasizing ever]. Thats why for example in congestive heart failure, the energy level of the heart continues to go down and down until the patient finally dies.
In Fibromyalgia, the energy keeps going down and down and the pain goes up and up and all that is because the cell is in a constant state of energy starvation and thats because the cell can never make enough ribose to recharge. There is never enough ribose to be made because glucose is preserved for other things, so if we bypass the rate limiting pentose phosphate pathway, and give ribose to the tissues, we can accelerate synthesis of ATP, rebuild the energy substrate pool and recharge the cell. Thats the sole function of ribose in tissue. It does not affect ATP turnover efficiency. It replaces purines lost through oxygen deprivation either thru exercise or high intensity work or disease. Fibromyalgics have faulty metabolism of ATP.
Ischemia: On the face it is defined as lack of blood flow to a tissue. In hearts that would be coronary artery disease reducing blood flow to heart muscle itself so the muscle doesnt get enough oxygen as in atherosclerosis. In peripheral muscle, ischemia is caused from peripheral vascular disease, blood clot and like in body building when trying to lift a heavy weight and the muscle becomes very tense, it squeezes the blood vessel and the muscle becomes ischemic. Anytime there is an ischemic condition, the net effect is there is not enough oxygen going to the tissue.
Other things cause oxygen deprivation besides ischemia simply high intensity exercise that causes us to use more energy than we can make through the oxidation pathways and we go into hypoxia where there is simply not enough oxygen being delivered. The blood flow might still be high but we use more energy than we can recover through breathing air. So when you exercise and start to pant or run up stairs and run out of breath, its because we are in oxygen debt; we cant breathe enough oxygen to get enough oxygen to the tissue to keep pace with energy turnover. [end quotes]
Who needs supplemental ribose?
Everyone needs ribose. It 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 reach new heights. Ribose helps the heart and muscles to 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. Anyone who has lost blood flow to the heart due to heart attack should consider ribose supplementation immediately.
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, reduced blood flow to the
periphery of the body, fatigue and decreased exercise tolerance. Ribose is the key nutrient for quickly restoring cardiac energy stores.
Although ribose is a sugar, it is not used in the body as is glucose, but rather set aside and used only in the manufacture of ATP, letting glucose provide the other cellular needs. It does not raise blood glucose levels or create an insulin spike; and in fact, has a slight hypoglycemic effect so sometimes it becomes necessary to take it with a carbohydrate to prevent fluctuation.
Research findings on benefits of ribose:
Restores energy to muscles through ATP production
Improves skeletal muscle strength and endurance ability.
Increases exercise tolerance in fibromyalgics; enhances performance, decreases muscle pain, stiffness and fatigue.
In healthy normal hearts, increases the anaerobic threshold and delays the onset of ischemic injury by 26%
Reduces heart rate of athletes working at constant workload and controls free-radical damage normally resulting from high-intensity exercise
Works to restore cellular energy lost to hypoxia or ischemic muscle
Provides a non-drug alternative in cases of congestive heart-failure and ischemic disease-Improves diastolic heart function and increases cardiac energy reserves that are depressed during ischemia, hypoxia associated with cardiovascular disease or congestive heart failure, ischemia and cardiomyopathy.
Is highly beneficial to patients undergoing off pump by-pass surgery.
Teleconference notes on Diastolic Dysfunction.
Dr. Johnson refers to research from Mayo Clinic 2003 published in JAMA and says this study indicated everyone (in the study) over 40 male or female had diastolic dysfunction (DD) some mild; some severe and had no idea they had this dysfunction. DD goes directly to energy levels. There is a clear temporal relationship between energy levels in the heart and DD.
Millions of people have cardiac diastolic dysfunction that have no idea they have it. Every single person over the age of 40 should definitely be taking ribose. Not only as a prophylactic for just maintaining normal healthy energy but for increasing the anaerobic threshold of the heart to protect heart from ischemia or hypoxic stress and in the case they may have DD, ribose is perfect to help that condition.
Diastolic - the diastolic phase is the relaxation phase and the heart fills and if the heart cant relax enough, then it cant fill and it creates pressure on the ventricle wall that makes it difficult to fill, doesnt allow it to expand and consequently cant pump enough blood. So diastolic function the ability of the heart to relax is extremely important to provide enough blood flow (volume) with each beat. When there is DD in the heart, the ventricle wall gets stiff , thick, loses compliance and thats why the heart hypertrophies. So enlarged hearts are typically generated from loss of diastolic function loss of the ability to relax. DD eventually leads to Congestive Heart Failure.
[www.bioenergy.com]
In MVP, many dont know they have it w/prolapse, you may not get enough blood into the ventricle as would like to have and the stroke volume can go down.
When the heart relaxes, the ventricle creates a vacuum and that vacuum sucks blood from the atrium before the atrial heart beat and the more blood that is sucked into the ventricle before the atrial beat, the better because it makes the atrial heart beat more efficient and fills the ventricle better. When there isnt good diastolic function, that vacuum is not created and the amount of blood that flows from the atrium to the ventricle goes down thats called atrial contribution. You want the AC to be high. In 2003 or 04 Eurp J. Heart Failure research we published showed very clearly in a crossover study that giving ribose to CHF patients increases atrial contribution it helps the heart relax very important.
More Notes:
Athletes - Aerobic exercise.
Any athlete regardless of sport would do well on ribose. Anytime tissue goes hypoxic whether it is a burst of exercise like a sprint or a body builder or an endurance athlete what you consider an aerobic athlete like a runner a runner goes hypoxic all the time runs uphill; downhill or accelerate, they get hypoxic. Anytime a tissue gets hypoxic, you will have a loss of energy substrate from that tissue it can be more or less severe but it happens all the time.
Study back in 1999 U of Nebraska published in Current Therapeutics Research took a number of male body builders and put on ribose or placebo for 28 days with a normal body building regimen After 28 days ribose group showed a significantly greater gain in both strength and endurance than placebo group showing that the training effect was enhanced with ribose administration.
Ribose is not a stimulant will not make you run faster or jump higher the first time you take it. What it does is keep muscle and heart in better physiological condition so that over time the training effect is enhanced.
In our opinion, every athlete should take ribose to preserve the energy charge of their tissue and to keep in good physiological health.
Use of Ionotropes - Patient on Coreg with low Ejection Fraction - help with positive remodeling, they hope.
Typically, the relationship between energy charge and systolic function is not a good one. It does not take much energy in a relative sense for the heart to contract; it takes a lot more energy interestingly enough, for the heart to relax. They are working on a study on the effect of ribose and BNP levels in Congestive Heart Failure that goes to the whole issue of remodeling. Havent answered that yet so I cant really say about Coreg and remodeling, but I can tell you as a practical matter, systolic function is generally not an energy-dependent problem there are normally other things happening there. Its important to note that a lot of patients with poor EF are put on ionotropes that really create more problems than good in the heart obviously they help the heart beat faster but create a great number of problems because when hearts are not pumping very hard and the EF does down and cardiologists give ionotropes to those hearts one of the reasons they arent working well is because they dont have enough energy so with ionotropes to force the pump function to go up forces the heart to beat harder they are asking the heart to use more energy and it doesnt have the energy to use.
Dr. Sinatra explains in his book and we continue to emphasize this issue that any time patients are given anything to improve the contractibility of the heart, they need to be given ribose to make sure they arent driving purines out of the heart at a pace faster than they can be replaced. So Coreg patients may have extreme fatigue and most cardiologists dont understand this.
In CHF these hearts are known to be energy starved. Typically patients with CHF will present with 30-40% fewer energy substrates in their hearts than normal hearts this equates to shortness of breath, intolerance to exercise, fatigue or limitation on physical activity and as the disease progresses, the symptoms become more severe as the heart loses more and more energy. There are all kinds of complicated reasons why the heart loses energy but thats the net result. Weve studies CHF for a long time and we have presented and continue to present a number of papers at major scientific meeting linking at the effect of not only ribose in CHF but the whole impact of energy deprivation/energy starvation in CHF
Basically by helping cells to replace purines, these energy substrates and by capturing them before they are washed out of the heart, ribose actually increases the energy charge into the heart and that translates into better diastolic cardiac function, less fatigue, less shortness of breath, enhanced physical performance and increased quality of life. When these patients are taking ribose, they get more energy in their heart and simply feel better.
Keep in mind that CHF probably more than any other heart disease also affects peripheral muscles as well as the heart so that explains many of the problems that are present w/shortness of breath with these patients. Because these hearts are functioning so poorly, they cant get enough blood flow to their legs so they have muscle pain in the legs called intermittent claudication when walking. If we can restore energy levels in the peripheral muscles, we help the whole patient and not just the heart. There is a lot of science on this subject; a lot of science looking at ribose in heart disease generally ischemic disease and with CHF. That research has been going on for 15 years and we continue to be contributors to that science in that area. Science backs up ribose in cardiac surgery, FM, CFS . We take a strong posture in research in our company.
Ribose taken orally and IV protects the heart from ischemia and allows the heart to do more work with less oxygen. It is an important compound for stimulating energy synthesis in tissue. There is nothing that does what it does. No other compound that the body can use to do the important work ribose does in the tissue. There is no drug, no other natural compound, nothing else that does what ribose does.
Surgical patients open heart CABAG bypass or for valve repair Two ways surgery done heart cooled/ body cooled/ blood pumped away from heart into a bypass machine, oxygenated there and put back in the body around the heart bypasses the heart. Heart is stopped; during the time the heart is stopped no oxygen going to the heart a solution called cardioplegia solution helps to reduce metabolic stress on the heart but since no oxygen going to the heart, it continues to use its own ATP- its own energy, but cant replace it. No metabolism occurring in a positive way in the heart so the heart loses all the important energy compounds continues to use energy at a slower rate but cant replace it. So surgery puts a great strain on heart thats been stopped for surgery.
The other way off pump CABAG called Beating Heart Surgery heart is cooled/ slowed way down and not much oxygen gets to the heart so even though some energy replacement is occurring, its metabolism is slowed and is not being very efficient. In either case, the energy is lost from the heart and it takes a long time for the heart to recover. Study with ribose during and after surgery IV and some on glucose - the glucose patients lost heart function after surgery and took several days for function to come back while ribose pts showed strong heart function right from the beginning. A California MD David Percholski ? - off pump surgeon -chief cardiothoracic surgeon at Saddleback hospital in San Diego Scripps - has done hundreds of patients using ribose in off pump surgery giving orally, pre-op, so he can load the heart w/energy before he does the surgery. Already one paper as a result of this surgery and another at an Intl Conference (05). He found by loading the heart w/ribose before surgery, he had a 49% improvement in cardiac index immediately following surgery indicating hearts with ribose were stronger and functioned better as a result of having more energy on board.
[end of notes/quotes]
[Dr. Sinatra indicates integrative cardiologist, Jim Roberts of Toledo, Ohio, is also using ribose with his cardiac patients.]
Summary
There can be no doubt that ribose administration stimulates purine metabolism and accelerates cellular energy recovery when tissues face periods of metabolic stress. Depressed cellular energy levels contribute to a myriad of physiological conditions affecting muscle function and performance, including:
Muscle stiffness, soreness, weakness and delayed recovery from exercise
Cell membrane and muscle fiber damage
Edema, swelling and electrochemical disruption
Activation of protease and phospholipase that attack the cell
Free radical formation and attack on
Cell membranes
Mitochondria
Delayed onset muscle soreness (DOMS)
Fatigue
Delayed macromolecule synthesis
By maintaining cellular energy charge, controlling cellular purine loss, and increasing energy synthesis and salvage ribose helps alleviate these symptoms, speeds recovery from exertion, and offsets cell and tissue damage caused by overtraining.
How to use:
Dosing: 5 grams is a dose or one rounded teaspoon of powder. Be sure to read labels as dose/size can be misleading. (Capsules are convenient and portable, but one dose means taking six capsules.)
Some dosage measurements are confusing. Some products provide a scoop its best to use that scoop. 5 ml = one teaspoon. The dose is a rounded teaspoon so measure a scoop into a teaspoon and note the variance. Some doses call for 2 scoops for one dose.
Multiple 5-gram doses separated by 30 - 45 minutes can be taken without side effects.
For energy enhancement, ½ to 1 teaspoon (about 2 5 grams) is generally adequate. Ribose is mildly sweet and completely soluble. It mixes easily with your favorite juice, milk, or other cold foods such as yogurt. (and water).
To maximize athletic performance, or to keep energy pools high during strenuous activity, slightly larger doses may be required. Ribose should be taken just before and just after exercise or activity. For extended exercise, an additional 1- 2 grams per hour of exercise or activity may be helpful. It's great in your water bottle! You'll forget it's there but your body won't.
Additional notes from the teleconference:
Dosing: 5 10 grams
Pre sports competition:
Endurance - 2.5 gms pre; 2.5 gms during and 2.5 gms after.
High intensity endurance 5 10 grams 7.5 is good in three doses Smaller more frequent doses are better than one large.
The half-life in blood is about 30 minutes it gets to the tissue and is metabolized in the PPP back to glucose. So more frequent doses particularly into endurance athletes really helps maintain energy level in tissue.
If an athletes tissue runs out of energy or even any healthy normal person who overworks their muscle like in the garden and not used to it the muscle becomes sore and stiff because of the tissue runs out of energy. The late onset muscle soreness that lasts for 3 4 days after exercise is caused from loss of energy substrates from the tissue. If we can replace or better still keep from leaking out at all, then the muscle doesnt get sore and the muscle stays in better physiological condition so the 2.5 gram dose 3 times during a long competition is ideal. Helps preserve energy so cells can utilize calcium better and as a result, they dont get sore muscles. A lot of athletes take it for post-exercise recovery just for that reason.
Heart Attack Recovery
5 grams 2 3 times a day with meals or in juice. Ribose does create mild hypoglycemic effect great for functional food applications because it is a good carb and doesnt contribute to an insulin spike and doesnt contribute to glycemic load so taking a little bit of juice or milk or fruit 3 times a day for MI patients. After been on for a couple weeks and energy levels in hearts are starting to recover, they can then titrate themselves back to 2 times a day and remain on 2 times a day.
5 grams 2 3 times a day is the dose for CHF, MI, FM, and heart surgery.
Since ribose is not stored in the cells in its free form, there really are no ribose deficiencies in tissue. Deficiencies refer to tissue concentrations of nutrients that fall to below-normal levels so a ribose deficiency does not exist. The cells are faced with the demand to produce in response to a specific metabolic demand. [Sinatra page 138]
An adequate dose of ribose will usually result in symptom improvement very quickly; sometimes within a day but typically within a few days. If the initial response is poor, the dose should be increased until the patient feels relief. The sicker the patient, the greater the improvement or relief in quality of life once the proper dose has been determined. [Sinatra p. 143]
In healthy people, like athletes wanting to attenuate the shaky, weak legs and fatigue following a fifty-mile bike ride, a smaller dose following the ride may be enough. Many athletes who work out in long training hours like to put ribose in their water bottles and take a second dose when they finish the workout. In healthy, normal but generally sedentary individuals who want to avoid muscle soreness and stiffness after strenuous exercise (delayed onset muscle soreness), they generally will get relief from a smaller dose taken both before and after the activity. [Sinatra 143]
Testing blood levels - The half life of ribose in the blood is around 30 minutes and then it is in the tissue so blood testing is not helpful.
Important: Once a patient finds relief from symptoms while taking ribose, they must remain on that dose as a relapse will occur quite rapidly.
Side Effects:
There are two known side effects of taking ribose in doses of 10 grams or more on an empty stomach. The first is a transient hypoglycemia (low blood sugar) that can be eliminated by taking larger doses of ribose with other carbohydrates (such as in juice). The second side effect that may occur in some individuals is loose stools. Again, this side effect has only been reported in very large doses, greater than 10 grams. Total daily intake of ribose should be limited to 20 grams, or approximately 4 rounded teaspoonfuls.
[I have found that even a 5 mg dose can sometimes create hypoglycemia for me depending if I take it on an empty stomach so I usually take it with a bit of juice or food as hypoglycemic effects are very unpleasant.]
Safety/Precautions:
Contraindications: None known. Studies have been done with all types of drugs and compounds and no adverse effects were noted.
Type 2 Diabetics: The genuine product is safe as it does not add additional sugar but actually creates a slight hypoglycemic effect so diabetics need to be aware of that potential.
Type 1 Diabetics should check with their doctor before taking a ribose product.
[Be aware that imposter brands may adulterate with a sucrose that could raise blood sugar. If the price sounds too good to be true, it probably is.]
As with all nutritional supplements, pregnant women, breast feeding mothers and children should consult their physician before use. Use under medical supervision.
Not for parenteral use.
Food Sources Ribose
Dr. Sinatra writes in his book that while ribose is naturally present in foods, it is found in only very small amounts that are not readily available to contribute physiologically. Its primary dietary source is red meat, particularly veal, where it is found as a major constituent of the nucleic acids that are abundantly available in muscle. The dietary intake of ribose is insufficient to provide any meaningful nutritional support, especially to those suffering with pathophysiological disorders such as heart disease, neuromuscular disease, peripheral vascular disease, etc or are hoping to recover quickly from hypoxic exercise. While D-ribose is synthesized in every cell in the body, it is very slow and to varying degrees depending on the tissue.(p. 135)
Brands and Labeling
Ribose is protected by the BioEnergy patents. Any product you consider, should be so labeled with the patent numbers and may also have a reference to BioEnergy and should say 100% ribose. Beware of cheaper products without appropriate labeling as it would be easy dilute ribose powder with table sugar. Expect to pay around $44 for a months supply of ribose. More if you use higher doses. Read labels to determine what the dosage equivalent is since 5 grams or one rounded teaspoonful is a single dose and many products are labeled as using ½ a teaspoon so the cost for a 5 mg. dose is actually double whats indicated unless you plan to use the 2.5 gram doses. Sources for Ribose Purchase just a few of many:
BioEnergys product under the name CorValen
[www.corvalen.com]
Designs for Health, Bridgeport Connecticut
This is BioEnergys product
[www.rockwellnutrition.com]
[www.rockwellnutrition.com]
[www.opthealth.com]
[www.needs.com]
Jarrows D-Ribose through iherb is 100% BioEnergy Ribose.
Note the dosage. It takes 2 scoops to equal one dose so calculate the cost accordingly. The container says 100 ½ teaspoon servings so the 200 gram bottle is actually a bit less than 50 days dosage as the teaspoons should be rounded.
Dr. Sinatra is quick to point out that the heart needs a triad or synergy of three essential nutrients for heart energy Coenzyme Q10, L-Carnitine and D-Ribose. He says: If you want to seriously take care of your heart, or you find yourself struggling to get the energy you want, RiboBoost (his product) may be what you need.
Heres why. Your heart is your energy centerit uses the most energy, and it produces the most. ATP (adenosine triphosphate) is the natural compound in your body that your cells burn for energy. It has a job description like no other. All of your tissues, including your heart and skeletal muscles, liver, and brain cells, need ATP to function. And D-Ribose helps to regenerate ATP.
Under normal conditions, your body is able to produce the amount of ATP that you need. However, under stressful conditions, such as strenuous exercise, or when your blood and oxygen flow is restricted, your ATP production may naturally decrease by as much as 50%. And studies have shown that it can take more than three days for depleted energy levels to return to normal, and up to ten days for full cardiac recovery.
He says that despite the overwhelming scientific evidence in over 100 clinical and scientific investigations on the beneficial role of ribose in energy-distressed tissue, very few American physicians have ever heard of ribose outside of their first year medical school biochemistry classes. Few have any idea how it works, or that it works, and fewer still recommend to patients. (p. 134)
RiboBoost helps to fuel the regeneration of ATPkeeping your heart strong, and energy levels where they should be. And the benefits it gives you are sixfold. www.drsinatra.com
Stephen Sinatra has Ribo-Boost through his website and uses CorValen [www.drsinatra.com]
There are a lot of products out there with the Ribose label so choose an authentic label. There may be imposters so buyer beware.
References and Resources
Teleconference: Clarence Johnson, PhD, BioEnergy Clinical Benefits of Ribose For Cardiovascular Function & Energy Production
Notes and copy from BioEnergy website and product data sheet from Designs for Health -
BioEnergy: Play the video its aimed at customers wanting to incorporate ribose into their products, but nicely explains the benefits of ribose in a quick presentation. [www.impactmovie.com]
[www.bioenergy.com] - this is the site to find all the papers and research by BioEnergy and Clarence Johnson, PhD. (Look under the Science tab)
[www.bioenergy.com]
[www.corvalen.com]
[www.bioenergy.com]- 105 abstracts on ribose.
[www.ispub.com]
Chapter 6 is 30 pages on D-Ribose The Sugar of Life The Missing Link
The Sinatra Solution, Stephen Sinatra, MD, Basic Health Publications, C2005
Recent Press Release:
MINNEAPOLIS, MN., May 11, 2006 - The European Patent Office and the Chinese Patent Office recently awarded new patents to Bioenergy for the use of D-Ribose in treating coronary artery disease and congestive heart failure. These recent patent approvals add to Bioenergy's growing intellectual property estate that now includes a pair of European patents, 14 U.S. patents, four patents from Great Britain, two from New Zealand and one from Australia. The company also has several U.S., European, Chinese and Japanese patents still in prosecution. "For a relatively small company like ours to accumulate this kind of patent portfolio really is a staggering achievement," states Bioenergy CEO Clarence Johnson. "Our patent estate gives us very solid protection for the sale of ribose in major markets around the world."
A large and growing body of clinical data shows that ribose therapy can increase the hypoxic threshold and improve diastolic heart function, meaning the heart can do more work and function better even with less oxygen. Increasing oxygen utilization in heart patients translates to increased exercise tolerance and enhanced quality of life. "In the study we presented to the European Patent Office involving patients with congestive heart disease and compromised systolic and diastolic function, we showed that even relatively small doses of D-ribose have a dramatic impact on heart function," explains Bioenergy, Inc.'s Medical Director John St. Cyr, MD, PhD. "Congestive heart failure and ischemic heart disease patients frequently have a very hard time with even minimal exercise. We showed that ribose significantly improves heart function and that translates to an improved ability to exercise. If the heart works more efficiently and patients are better able to participate in daily activities, their quality of life is improved." These patents for use in enhancing physical rehabilitation in heart patients follow others, including the use of ribose by healthy people to promote muscle recovery following exercise or strenuous work and to reduce cramping, stiffness and soreness. High-intensity exercise drains muscle energy pools, contributing to muscle soreness, fatigue, loss of peak performance and even tissue damage. Ribose has been proven to accelerate tissue energy recovery and aid in restoring the physiological condition of muscle. That reduces cell damage and protects the heart and muscles from the rigors of strenuous exercise.
Scientific Rationale for the Nutritional Use of D-Ribose to Support Skeletal Muscle Health and Function [www.bioenergy.com]
[note the section marked **]
Conclusion
High-intensity exercise, muscle ischemia, or localized hypoxia overwhelms the cellular energy turnover mechanisms, oxidative phosphorylation, glycolysis, and the creatine kinase reaction. The resulting energy demand/supply mismatch leads to a cascade of reactions that drain purines from the cell and deplete the cellular energy, or adenylate, pool. This loss of energy substrates is a metabolic disaster to the cell because re-supply is slow and metabolically costly, and the resulting depletion in energy availability contributes to a variety of physiological conditions, including muscle stiffness, weakness, pain, cell damage, and depressed levels of protein synthesis.
D-Ribose stimulates the purine nucleotide pathway associated with salvage and de novo synthesis of purine nucleotides, reduces cellular purine loss, and accelerates energy recovery in the cell. Through this action, cellular energy charge is preserved and physiological consequences of depleted cellular energy are reduced.
Excerpts -
When muscles prepare to contract, calcium from the extracellular space and the sarcoplasmic reticulum rushes into the cytosol to form cross-links allowing the muscle to contract. Following contraction, this calcium must be physically pumped out of the cytosol. The calcium pumps function at high energetic cost because they are pumping calcium out of the cytoplasm against a concentration gradient of ~1:10,000. A disruption in calcium pump function retains calcium in the cytosol, having the effect of impairing muscle relaxation.
In hearts, this ultimately leads to diastolic dysfunction and angina, while in skeletal muscle it contributes to muscle stiffness, free radical formation, activation of proteases and phospholipases that attack structural proteins of the cell, and muscle pain known as delayed onset muscle soreness (DOMS) (Figure 2).
Any condition causing localized decrease in muscle oxygen tension has the effect of depleting the cellular energy pool. This reduction in energy status disrupts calcium management, creating muscle tension, stiffness, soreness, and fatigue. The increase in intracellular Ca++ causes a concomitant efflux of K+ that activates pain receptors on the cell membrane. Pain adds further to muscle tension, exacerbating the energy drain and continuing the cycle.
Chronic ischemia, hypoxia or repeated bouts of high-intensity exercise have the effect of driving purines out of the cell and lowering cellular energy charge (Figure 3). It is the frequency and severity of hypoxia that determines the rate and degree of energy depletion. In untrained subjects, a single bout of high-intensity exercise may be sufficient to drain energy reserves and contribute to muscle stiffness and soreness. However, in trained muscle repeated bouts of high-intensity exercise over several days may be required. In athletes energy depletion contributes to overtraining effect, causing muscle pain, weakness, and physiological damage to the muscle.
Free Energy of Hydrolysis of ATP Determines Functional Status of Muscle
The free energy of hydrolysis of ATP (ÄG~ATP) defines the energy status of the cell and describes the chemical driving force within the cell that is available to complete biochemical reactions. The ÄG~ATP is expressed as a negative number, meaning the hydrolysis of ATP is far from equilibrium and that hydrolysis of ATP to ADP + Pi contributes to an increase in entropy. Without getting into a discussion of the second law of thermodynamics, simply note that the less negative the ÄG~ATP becomes, the less chemical driving force there is in the cell. Therefore, if the cell has a high negative number it has more energy available to drive biochemical reactions through the ATPase enzymes involved in cell function.
Normal, healthy heart and muscle cells have ÄG~ATP of -56 kJ or greater (to a maximum of ~-70 kJ). As long as the free energy stays at or above -52 kJ the cell will have enough energy to drive all its biochemical reactions and will function normally.
**However 12 minutes of hypoxia are sufficient to drive the ÄG~ATP below -52 kJ, meaning the cellular calcium pumps will begin to fail. Prolonged pump failure contributes to diastolic cardiac dysfunction, skeletal muscle stiffness, weakness, and soreness and cell damage. Muscle contraction will continue to function normally.
**Continued energy drain will lower the free energy of hydrolysis further. Several more minutes of hypoxia will drive the ÄG~ATP below -48 kJ, at which time the cellular ion pumps fail. Now, cellular edema, cell leakage, and cell wall damage occurs. Further, the electrochemical gradient across the cell membrane can be disrupted. In hearts, this contributes to systolic cardiac dysfunction and arrhythmia.
12 minutes of zero flow ischemia depletes cellular energy to the point at which contractile mechanisms fail. Except for conditions of extreme anoxia and energy depletion contraction will continue and force development will be largely unaffected. Prolonged hypoxic exercise contributes to cell and muscle damage and delayed recovery, but has little impact on short-term force development.
=====================================================
Gross, G, J Auchampac. Role of ATP dependent potassium channels in myocardial ischaemia. Cardiovasc Res 1992; 26:1011-1016.
Recently, a class of potassium (K) channels has been discovered which are regulated by the intracellular level of ATP. These channels have been termed ATP dependent K channels (KATP) and have been found to exist in the heart, skeletal muscle, pancreatic beta cells, brain, and smooth muscle. In this article, we discuss the function of the KATP channel in the ischaemic myocardium and present evidence to suggest that activation of these channels may, on one had result in a marked cardioprotective effect from reversible or irreversible electrical, functional or biochemical change, or on the other hand, have the potential to produce electrical instability and a proarrhythmic effect. The therapeutic potential of potassium channel modulators is also discussed.
The End
I toyed with the idea of titling this Miracle Nutrient or using Dr. Sinatras tag, "D-Ribose, The Sugar of Life The Missing Link.
For over 18 months, Ive been experimenting with ribose supplementation and I wanted to call your attention to this important nutrient not only for cardiac function, but overall muscle function as well. Endurance athletes will be especially interested in the benefits of ribose. Ribose has been proven to accelerate tissue energy recovery and aid in restoring the physiological condition of muscle. That reduces cell damage and protects the heart and muscles from the rigors of strenuous exercise.
When I heard cardiologist Stephen Sinatra speak passionately about the benefits of ribose and his clinical experiences, I was interested but didnt act on the information for a few months. His mention that it was highly beneficial for helping fibromyalgics got my attention. A few months later, because I attended the 2004 Anti Aging Congress, I was sent a complementary copy of his book, The Sinatra Solution. Its all about nutritional support for heart tissue and help for heart conditions. I read about ribose and began my own experiment of one.
Then I heard a nutritional teleconference featuring PhD biochemist, Clarence Johnson, President and CEO of BioEnergy, Inc., the developer of ribose-based products marketed under several names including CorValen. This was my primary motivation to continue experimenting with ribose dosage.
I want to share some of the basic reasons why ribose is important and direct you to resources for your own research if this stimulates your interest. This is my mission part, create awareness.
At the BioEnergy research library, I even found a very relevant portion indicating a link to arrhythmia. That reference is at the very end of this post in the excerpt of the article, Scientific Rationale for the Nutritional Use of D-Ribose to Support Skeletal Muscle Health and Function. Also included at the end is a reference to potassium channels regulated by the intracellular levels of ATP and a potential to produce electrical instability and pro-arrhythmic effect.
First, a bit of background:
BioEnergy holds 26 patents or pending in the US and abroad on ribose products for a variety of uses. The company was founded by a pediatric cardiovascular surgeon in 1986, John Foker, also a PhD biochemist. Dr. Johnson joined him in research and eventually became part of the management. Originally, D-ribose was a very expensive raw material which limited practical, wide-spread use, but a method of making it through a natural fermentation process was developed and it is now more affordable. Ribose metabolism was discovered in 1944 but it wasnt until the mid-80s and with Dr. Fokers work, that it was connected to cardiac function. Not much has been heard about it until the last 3 4 years. Dr. Sinatra is actively promoting its use and now other forward-thinking cardiologists are using it with impressive results.
Its not just the heart muscle that benefits, but also skeletal muscles and post exertional recovery. For heart protection and energy, ribose is invaluable.
When I was listing to Dr. Johnson, I once again had that ah ha moment of enlightenment and I was motivated to pursue the ribose connection and why it would be helpful for my fibromyalgia symptoms and also my heart. I was not disappointed in finding substantial data. This is a functional nutrient that is well researched.
My Experience:
When I began my experiment, I was almost sorry I no longer had afib, but I knew my heart would benefit regardless so I was looking forward to confirming what many studies indicate that ribose enables those with fibromyalgia to be free of pain and fatigue. The results were almost immediate and miraculous. I experimented with doses - stopping and starting again, just to be sure. It was true. The symptoms are diminished by 99%. My fatigue has diminished as well; my energy and stamina have definitely improved.
Additionally, my heart feels solid and strong and the minor bursts of sinus tachycardia have diminished to clinically insignificant in frequency. If I had afib today, Id be taking ribose regularly, along with CoQ10 and maybe L-Carnitine and definitely taking it during an event to avoid that dragged out feeling afterwards.
The literature on ribose is abundant. I wont belabor this into hugely lengthy technical report but I am duplicating some of the data from BioEnergys research to explain why ribose is beneficial to heart cells and why it benefits those who exercise, especially those who train vigorously. References are listed for those wishing to do more research. Im providing highlights; and you can decide what to do with this information. Over 100 scientific publications describe the beneficial effects of ribose in heart and muscles. Bottom Line: Ribose is cutting edge.
Knowledge is power,
Jackie
[Following are excerpts and quotes see references]
What is Ribose?
D-Ribose is a mildly-sweet tasting powder and is a simple 5-carbon monosaccharide used by all living cells as an essential compound in cellular energy metabolism. Ribose, needed to synthesize adenine nucleotides, is the carbohydrate backbone of genetic material - DNA and RNA, certain vitamins, and other important cellular compounds.
Ribose is a carbohydrate (sugar) naturally found in all cells of the body. Physical stress can increase the loss of nucleotides (such as ATP, ADP and AMP) from the hearth and skeletal muscles. Ribose metabolizes into 5-phophoribosyl-1-pyrophosphate (PRPP), which is a rate limiting substance used in the synthesis of nucleotides.
Without ribose, tissues could not produce these life-giving compounds. Adenine nucleotides are required by heart, muscle and other tissue to make adenosine triphosphate (ATP), the primary source of energy used by all cells to maintain normal health and function. When the pool of adenine nucleotides is depressed by disease or strenuous exercise or activity, the level of energy available to the cell is compromised. A reduction in cellular energy level can lead to diminished function and reduced physiological health.
Unfortunately, many tissues, including heart and skeletal muscles, do not have the metabolic machinery to make ribose quickly when it is needed to rebuild energy levels that might be depressed by disease, exercise or strenuous activity. As such, when these tissues come under metabolic stress, they may not be able to adequately maintain energy pools. A reduced capacity for energy maintenance may impact tissue health and normal function. Forming ribose in heart and muscle cells is a slow process. As a result heart and muscle tissues are unable to replace energy pools quickly once they have been depleted by disease or exercise.
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 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 heart and muscles in good physiological condition, increase power and endurance, and reduce fatigue. Recent research has also shown that ribose supplementation during exercise reduces free radical formation and lowers cardiac stress associated with hypoxia.
Dr. Johnson says: In normal healthy hearts that have been stressed with ischemia or hypoxic insult, research shows that it takes more than 10 days to fully recover the energy charge. Thats in a normal healthy heart. In muscle, we know it takes more than 3 days because weve done all the studies to show the ATP recovery rate in skeletal muscle following exercise and we know it to be greater than 3 days.
So, with a chronic case of oxygen deprivation, like in heart disease or what I call chronic exercise when people exercise every day or when high intensity exercise every day or every other day, and the oxygen deprivation is repeated, the tissue simply cant make ribose fast enough to ever recover. [note emphasizing ever]. Thats why for example in congestive heart failure, the energy level of the heart continues to go down and down until the patient finally dies.
In Fibromyalgia, the energy keeps going down and down and the pain goes up and up and all that is because the cell is in a constant state of energy starvation and thats because the cell can never make enough ribose to recharge. There is never enough ribose to be made because glucose is preserved for other things, so if we bypass the rate limiting pentose phosphate pathway, and give ribose to the tissues, we can accelerate synthesis of ATP, rebuild the energy substrate pool and recharge the cell. Thats the sole function of ribose in tissue. It does not affect ATP turnover efficiency. It replaces purines lost through oxygen deprivation either thru exercise or high intensity work or disease. Fibromyalgics have faulty metabolism of ATP.
Ischemia: On the face it is defined as lack of blood flow to a tissue. In hearts that would be coronary artery disease reducing blood flow to heart muscle itself so the muscle doesnt get enough oxygen as in atherosclerosis. In peripheral muscle, ischemia is caused from peripheral vascular disease, blood clot and like in body building when trying to lift a heavy weight and the muscle becomes very tense, it squeezes the blood vessel and the muscle becomes ischemic. Anytime there is an ischemic condition, the net effect is there is not enough oxygen going to the tissue.
Other things cause oxygen deprivation besides ischemia simply high intensity exercise that causes us to use more energy than we can make through the oxidation pathways and we go into hypoxia where there is simply not enough oxygen being delivered. The blood flow might still be high but we use more energy than we can recover through breathing air. So when you exercise and start to pant or run up stairs and run out of breath, its because we are in oxygen debt; we cant breathe enough oxygen to get enough oxygen to the tissue to keep pace with energy turnover. [end quotes]
Who needs supplemental ribose?
Everyone needs ribose. It 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 reach new heights. Ribose helps the heart and muscles to 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. Anyone who has lost blood flow to the heart due to heart attack should consider ribose supplementation immediately.
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, reduced blood flow to the
periphery of the body, fatigue and decreased exercise tolerance. Ribose is the key nutrient for quickly restoring cardiac energy stores.
Although ribose is a sugar, it is not used in the body as is glucose, but rather set aside and used only in the manufacture of ATP, letting glucose provide the other cellular needs. It does not raise blood glucose levels or create an insulin spike; and in fact, has a slight hypoglycemic effect so sometimes it becomes necessary to take it with a carbohydrate to prevent fluctuation.
Research findings on benefits of ribose:
Restores energy to muscles through ATP production
Improves skeletal muscle strength and endurance ability.
Increases exercise tolerance in fibromyalgics; enhances performance, decreases muscle pain, stiffness and fatigue.
In healthy normal hearts, increases the anaerobic threshold and delays the onset of ischemic injury by 26%
Reduces heart rate of athletes working at constant workload and controls free-radical damage normally resulting from high-intensity exercise
Works to restore cellular energy lost to hypoxia or ischemic muscle
Provides a non-drug alternative in cases of congestive heart-failure and ischemic disease-Improves diastolic heart function and increases cardiac energy reserves that are depressed during ischemia, hypoxia associated with cardiovascular disease or congestive heart failure, ischemia and cardiomyopathy.
Is highly beneficial to patients undergoing off pump by-pass surgery.
Teleconference notes on Diastolic Dysfunction.
Dr. Johnson refers to research from Mayo Clinic 2003 published in JAMA and says this study indicated everyone (in the study) over 40 male or female had diastolic dysfunction (DD) some mild; some severe and had no idea they had this dysfunction. DD goes directly to energy levels. There is a clear temporal relationship between energy levels in the heart and DD.
Millions of people have cardiac diastolic dysfunction that have no idea they have it. Every single person over the age of 40 should definitely be taking ribose. Not only as a prophylactic for just maintaining normal healthy energy but for increasing the anaerobic threshold of the heart to protect heart from ischemia or hypoxic stress and in the case they may have DD, ribose is perfect to help that condition.
Diastolic - the diastolic phase is the relaxation phase and the heart fills and if the heart cant relax enough, then it cant fill and it creates pressure on the ventricle wall that makes it difficult to fill, doesnt allow it to expand and consequently cant pump enough blood. So diastolic function the ability of the heart to relax is extremely important to provide enough blood flow (volume) with each beat. When there is DD in the heart, the ventricle wall gets stiff , thick, loses compliance and thats why the heart hypertrophies. So enlarged hearts are typically generated from loss of diastolic function loss of the ability to relax. DD eventually leads to Congestive Heart Failure.
[www.bioenergy.com]
In MVP, many dont know they have it w/prolapse, you may not get enough blood into the ventricle as would like to have and the stroke volume can go down.
When the heart relaxes, the ventricle creates a vacuum and that vacuum sucks blood from the atrium before the atrial heart beat and the more blood that is sucked into the ventricle before the atrial beat, the better because it makes the atrial heart beat more efficient and fills the ventricle better. When there isnt good diastolic function, that vacuum is not created and the amount of blood that flows from the atrium to the ventricle goes down thats called atrial contribution. You want the AC to be high. In 2003 or 04 Eurp J. Heart Failure research we published showed very clearly in a crossover study that giving ribose to CHF patients increases atrial contribution it helps the heart relax very important.
More Notes:
Athletes - Aerobic exercise.
Any athlete regardless of sport would do well on ribose. Anytime tissue goes hypoxic whether it is a burst of exercise like a sprint or a body builder or an endurance athlete what you consider an aerobic athlete like a runner a runner goes hypoxic all the time runs uphill; downhill or accelerate, they get hypoxic. Anytime a tissue gets hypoxic, you will have a loss of energy substrate from that tissue it can be more or less severe but it happens all the time.
Study back in 1999 U of Nebraska published in Current Therapeutics Research took a number of male body builders and put on ribose or placebo for 28 days with a normal body building regimen After 28 days ribose group showed a significantly greater gain in both strength and endurance than placebo group showing that the training effect was enhanced with ribose administration.
Ribose is not a stimulant will not make you run faster or jump higher the first time you take it. What it does is keep muscle and heart in better physiological condition so that over time the training effect is enhanced.
In our opinion, every athlete should take ribose to preserve the energy charge of their tissue and to keep in good physiological health.
Use of Ionotropes - Patient on Coreg with low Ejection Fraction - help with positive remodeling, they hope.
Typically, the relationship between energy charge and systolic function is not a good one. It does not take much energy in a relative sense for the heart to contract; it takes a lot more energy interestingly enough, for the heart to relax. They are working on a study on the effect of ribose and BNP levels in Congestive Heart Failure that goes to the whole issue of remodeling. Havent answered that yet so I cant really say about Coreg and remodeling, but I can tell you as a practical matter, systolic function is generally not an energy-dependent problem there are normally other things happening there. Its important to note that a lot of patients with poor EF are put on ionotropes that really create more problems than good in the heart obviously they help the heart beat faster but create a great number of problems because when hearts are not pumping very hard and the EF does down and cardiologists give ionotropes to those hearts one of the reasons they arent working well is because they dont have enough energy so with ionotropes to force the pump function to go up forces the heart to beat harder they are asking the heart to use more energy and it doesnt have the energy to use.
Dr. Sinatra explains in his book and we continue to emphasize this issue that any time patients are given anything to improve the contractibility of the heart, they need to be given ribose to make sure they arent driving purines out of the heart at a pace faster than they can be replaced. So Coreg patients may have extreme fatigue and most cardiologists dont understand this.
In CHF these hearts are known to be energy starved. Typically patients with CHF will present with 30-40% fewer energy substrates in their hearts than normal hearts this equates to shortness of breath, intolerance to exercise, fatigue or limitation on physical activity and as the disease progresses, the symptoms become more severe as the heart loses more and more energy. There are all kinds of complicated reasons why the heart loses energy but thats the net result. Weve studies CHF for a long time and we have presented and continue to present a number of papers at major scientific meeting linking at the effect of not only ribose in CHF but the whole impact of energy deprivation/energy starvation in CHF
Basically by helping cells to replace purines, these energy substrates and by capturing them before they are washed out of the heart, ribose actually increases the energy charge into the heart and that translates into better diastolic cardiac function, less fatigue, less shortness of breath, enhanced physical performance and increased quality of life. When these patients are taking ribose, they get more energy in their heart and simply feel better.
Keep in mind that CHF probably more than any other heart disease also affects peripheral muscles as well as the heart so that explains many of the problems that are present w/shortness of breath with these patients. Because these hearts are functioning so poorly, they cant get enough blood flow to their legs so they have muscle pain in the legs called intermittent claudication when walking. If we can restore energy levels in the peripheral muscles, we help the whole patient and not just the heart. There is a lot of science on this subject; a lot of science looking at ribose in heart disease generally ischemic disease and with CHF. That research has been going on for 15 years and we continue to be contributors to that science in that area. Science backs up ribose in cardiac surgery, FM, CFS . We take a strong posture in research in our company.
Ribose taken orally and IV protects the heart from ischemia and allows the heart to do more work with less oxygen. It is an important compound for stimulating energy synthesis in tissue. There is nothing that does what it does. No other compound that the body can use to do the important work ribose does in the tissue. There is no drug, no other natural compound, nothing else that does what ribose does.
Surgical patients open heart CABAG bypass or for valve repair Two ways surgery done heart cooled/ body cooled/ blood pumped away from heart into a bypass machine, oxygenated there and put back in the body around the heart bypasses the heart. Heart is stopped; during the time the heart is stopped no oxygen going to the heart a solution called cardioplegia solution helps to reduce metabolic stress on the heart but since no oxygen going to the heart, it continues to use its own ATP- its own energy, but cant replace it. No metabolism occurring in a positive way in the heart so the heart loses all the important energy compounds continues to use energy at a slower rate but cant replace it. So surgery puts a great strain on heart thats been stopped for surgery.
The other way off pump CABAG called Beating Heart Surgery heart is cooled/ slowed way down and not much oxygen gets to the heart so even though some energy replacement is occurring, its metabolism is slowed and is not being very efficient. In either case, the energy is lost from the heart and it takes a long time for the heart to recover. Study with ribose during and after surgery IV and some on glucose - the glucose patients lost heart function after surgery and took several days for function to come back while ribose pts showed strong heart function right from the beginning. A California MD David Percholski ? - off pump surgeon -chief cardiothoracic surgeon at Saddleback hospital in San Diego Scripps - has done hundreds of patients using ribose in off pump surgery giving orally, pre-op, so he can load the heart w/energy before he does the surgery. Already one paper as a result of this surgery and another at an Intl Conference (05). He found by loading the heart w/ribose before surgery, he had a 49% improvement in cardiac index immediately following surgery indicating hearts with ribose were stronger and functioned better as a result of having more energy on board.
[end of notes/quotes]
[Dr. Sinatra indicates integrative cardiologist, Jim Roberts of Toledo, Ohio, is also using ribose with his cardiac patients.]
Summary
There can be no doubt that ribose administration stimulates purine metabolism and accelerates cellular energy recovery when tissues face periods of metabolic stress. Depressed cellular energy levels contribute to a myriad of physiological conditions affecting muscle function and performance, including:
Muscle stiffness, soreness, weakness and delayed recovery from exercise
Cell membrane and muscle fiber damage
Edema, swelling and electrochemical disruption
Activation of protease and phospholipase that attack the cell
Free radical formation and attack on
Cell membranes
Mitochondria
Delayed onset muscle soreness (DOMS)
Fatigue
Delayed macromolecule synthesis
By maintaining cellular energy charge, controlling cellular purine loss, and increasing energy synthesis and salvage ribose helps alleviate these symptoms, speeds recovery from exertion, and offsets cell and tissue damage caused by overtraining.
How to use:
Dosing: 5 grams is a dose or one rounded teaspoon of powder. Be sure to read labels as dose/size can be misleading. (Capsules are convenient and portable, but one dose means taking six capsules.)
Some dosage measurements are confusing. Some products provide a scoop its best to use that scoop. 5 ml = one teaspoon. The dose is a rounded teaspoon so measure a scoop into a teaspoon and note the variance. Some doses call for 2 scoops for one dose.
Multiple 5-gram doses separated by 30 - 45 minutes can be taken without side effects.
For energy enhancement, ½ to 1 teaspoon (about 2 5 grams) is generally adequate. Ribose is mildly sweet and completely soluble. It mixes easily with your favorite juice, milk, or other cold foods such as yogurt. (and water).
To maximize athletic performance, or to keep energy pools high during strenuous activity, slightly larger doses may be required. Ribose should be taken just before and just after exercise or activity. For extended exercise, an additional 1- 2 grams per hour of exercise or activity may be helpful. It's great in your water bottle! You'll forget it's there but your body won't.
Additional notes from the teleconference:
Dosing: 5 10 grams
Pre sports competition:
Endurance - 2.5 gms pre; 2.5 gms during and 2.5 gms after.
High intensity endurance 5 10 grams 7.5 is good in three doses Smaller more frequent doses are better than one large.
The half-life in blood is about 30 minutes it gets to the tissue and is metabolized in the PPP back to glucose. So more frequent doses particularly into endurance athletes really helps maintain energy level in tissue.
If an athletes tissue runs out of energy or even any healthy normal person who overworks their muscle like in the garden and not used to it the muscle becomes sore and stiff because of the tissue runs out of energy. The late onset muscle soreness that lasts for 3 4 days after exercise is caused from loss of energy substrates from the tissue. If we can replace or better still keep from leaking out at all, then the muscle doesnt get sore and the muscle stays in better physiological condition so the 2.5 gram dose 3 times during a long competition is ideal. Helps preserve energy so cells can utilize calcium better and as a result, they dont get sore muscles. A lot of athletes take it for post-exercise recovery just for that reason.
Heart Attack Recovery
5 grams 2 3 times a day with meals or in juice. Ribose does create mild hypoglycemic effect great for functional food applications because it is a good carb and doesnt contribute to an insulin spike and doesnt contribute to glycemic load so taking a little bit of juice or milk or fruit 3 times a day for MI patients. After been on for a couple weeks and energy levels in hearts are starting to recover, they can then titrate themselves back to 2 times a day and remain on 2 times a day.
5 grams 2 3 times a day is the dose for CHF, MI, FM, and heart surgery.
Since ribose is not stored in the cells in its free form, there really are no ribose deficiencies in tissue. Deficiencies refer to tissue concentrations of nutrients that fall to below-normal levels so a ribose deficiency does not exist. The cells are faced with the demand to produce in response to a specific metabolic demand. [Sinatra page 138]
An adequate dose of ribose will usually result in symptom improvement very quickly; sometimes within a day but typically within a few days. If the initial response is poor, the dose should be increased until the patient feels relief. The sicker the patient, the greater the improvement or relief in quality of life once the proper dose has been determined. [Sinatra p. 143]
In healthy people, like athletes wanting to attenuate the shaky, weak legs and fatigue following a fifty-mile bike ride, a smaller dose following the ride may be enough. Many athletes who work out in long training hours like to put ribose in their water bottles and take a second dose when they finish the workout. In healthy, normal but generally sedentary individuals who want to avoid muscle soreness and stiffness after strenuous exercise (delayed onset muscle soreness), they generally will get relief from a smaller dose taken both before and after the activity. [Sinatra 143]
Testing blood levels - The half life of ribose in the blood is around 30 minutes and then it is in the tissue so blood testing is not helpful.
Important: Once a patient finds relief from symptoms while taking ribose, they must remain on that dose as a relapse will occur quite rapidly.
Side Effects:
There are two known side effects of taking ribose in doses of 10 grams or more on an empty stomach. The first is a transient hypoglycemia (low blood sugar) that can be eliminated by taking larger doses of ribose with other carbohydrates (such as in juice). The second side effect that may occur in some individuals is loose stools. Again, this side effect has only been reported in very large doses, greater than 10 grams. Total daily intake of ribose should be limited to 20 grams, or approximately 4 rounded teaspoonfuls.
[I have found that even a 5 mg dose can sometimes create hypoglycemia for me depending if I take it on an empty stomach so I usually take it with a bit of juice or food as hypoglycemic effects are very unpleasant.]
Safety/Precautions:
Contraindications: None known. Studies have been done with all types of drugs and compounds and no adverse effects were noted.
Type 2 Diabetics: The genuine product is safe as it does not add additional sugar but actually creates a slight hypoglycemic effect so diabetics need to be aware of that potential.
Type 1 Diabetics should check with their doctor before taking a ribose product.
[Be aware that imposter brands may adulterate with a sucrose that could raise blood sugar. If the price sounds too good to be true, it probably is.]
As with all nutritional supplements, pregnant women, breast feeding mothers and children should consult their physician before use. Use under medical supervision.
Not for parenteral use.
Food Sources Ribose
Dr. Sinatra writes in his book that while ribose is naturally present in foods, it is found in only very small amounts that are not readily available to contribute physiologically. Its primary dietary source is red meat, particularly veal, where it is found as a major constituent of the nucleic acids that are abundantly available in muscle. The dietary intake of ribose is insufficient to provide any meaningful nutritional support, especially to those suffering with pathophysiological disorders such as heart disease, neuromuscular disease, peripheral vascular disease, etc or are hoping to recover quickly from hypoxic exercise. While D-ribose is synthesized in every cell in the body, it is very slow and to varying degrees depending on the tissue.(p. 135)
Brands and Labeling
Ribose is protected by the BioEnergy patents. Any product you consider, should be so labeled with the patent numbers and may also have a reference to BioEnergy and should say 100% ribose. Beware of cheaper products without appropriate labeling as it would be easy dilute ribose powder with table sugar. Expect to pay around $44 for a months supply of ribose. More if you use higher doses. Read labels to determine what the dosage equivalent is since 5 grams or one rounded teaspoonful is a single dose and many products are labeled as using ½ a teaspoon so the cost for a 5 mg. dose is actually double whats indicated unless you plan to use the 2.5 gram doses. Sources for Ribose Purchase just a few of many:
BioEnergys product under the name CorValen
[www.corvalen.com]
Designs for Health, Bridgeport Connecticut
This is BioEnergys product
[www.rockwellnutrition.com]
[www.rockwellnutrition.com]
[www.opthealth.com]
[www.needs.com]
Jarrows D-Ribose through iherb is 100% BioEnergy Ribose.
Note the dosage. It takes 2 scoops to equal one dose so calculate the cost accordingly. The container says 100 ½ teaspoon servings so the 200 gram bottle is actually a bit less than 50 days dosage as the teaspoons should be rounded.
Dr. Sinatra is quick to point out that the heart needs a triad or synergy of three essential nutrients for heart energy Coenzyme Q10, L-Carnitine and D-Ribose. He says: If you want to seriously take care of your heart, or you find yourself struggling to get the energy you want, RiboBoost (his product) may be what you need.
Heres why. Your heart is your energy centerit uses the most energy, and it produces the most. ATP (adenosine triphosphate) is the natural compound in your body that your cells burn for energy. It has a job description like no other. All of your tissues, including your heart and skeletal muscles, liver, and brain cells, need ATP to function. And D-Ribose helps to regenerate ATP.
Under normal conditions, your body is able to produce the amount of ATP that you need. However, under stressful conditions, such as strenuous exercise, or when your blood and oxygen flow is restricted, your ATP production may naturally decrease by as much as 50%. And studies have shown that it can take more than three days for depleted energy levels to return to normal, and up to ten days for full cardiac recovery.
He says that despite the overwhelming scientific evidence in over 100 clinical and scientific investigations on the beneficial role of ribose in energy-distressed tissue, very few American physicians have ever heard of ribose outside of their first year medical school biochemistry classes. Few have any idea how it works, or that it works, and fewer still recommend to patients. (p. 134)
RiboBoost helps to fuel the regeneration of ATPkeeping your heart strong, and energy levels where they should be. And the benefits it gives you are sixfold. www.drsinatra.com
Stephen Sinatra has Ribo-Boost through his website and uses CorValen [www.drsinatra.com]
There are a lot of products out there with the Ribose label so choose an authentic label. There may be imposters so buyer beware.
References and Resources
Teleconference: Clarence Johnson, PhD, BioEnergy Clinical Benefits of Ribose For Cardiovascular Function & Energy Production
Notes and copy from BioEnergy website and product data sheet from Designs for Health -
BioEnergy: Play the video its aimed at customers wanting to incorporate ribose into their products, but nicely explains the benefits of ribose in a quick presentation. [www.impactmovie.com]
[www.bioenergy.com] - this is the site to find all the papers and research by BioEnergy and Clarence Johnson, PhD. (Look under the Science tab)
[www.bioenergy.com]
[www.corvalen.com]
[www.bioenergy.com]- 105 abstracts on ribose.
[www.ispub.com]
Chapter 6 is 30 pages on D-Ribose The Sugar of Life The Missing Link
The Sinatra Solution, Stephen Sinatra, MD, Basic Health Publications, C2005
Recent Press Release:
MINNEAPOLIS, MN., May 11, 2006 - The European Patent Office and the Chinese Patent Office recently awarded new patents to Bioenergy for the use of D-Ribose in treating coronary artery disease and congestive heart failure. These recent patent approvals add to Bioenergy's growing intellectual property estate that now includes a pair of European patents, 14 U.S. patents, four patents from Great Britain, two from New Zealand and one from Australia. The company also has several U.S., European, Chinese and Japanese patents still in prosecution. "For a relatively small company like ours to accumulate this kind of patent portfolio really is a staggering achievement," states Bioenergy CEO Clarence Johnson. "Our patent estate gives us very solid protection for the sale of ribose in major markets around the world."
A large and growing body of clinical data shows that ribose therapy can increase the hypoxic threshold and improve diastolic heart function, meaning the heart can do more work and function better even with less oxygen. Increasing oxygen utilization in heart patients translates to increased exercise tolerance and enhanced quality of life. "In the study we presented to the European Patent Office involving patients with congestive heart disease and compromised systolic and diastolic function, we showed that even relatively small doses of D-ribose have a dramatic impact on heart function," explains Bioenergy, Inc.'s Medical Director John St. Cyr, MD, PhD. "Congestive heart failure and ischemic heart disease patients frequently have a very hard time with even minimal exercise. We showed that ribose significantly improves heart function and that translates to an improved ability to exercise. If the heart works more efficiently and patients are better able to participate in daily activities, their quality of life is improved." These patents for use in enhancing physical rehabilitation in heart patients follow others, including the use of ribose by healthy people to promote muscle recovery following exercise or strenuous work and to reduce cramping, stiffness and soreness. High-intensity exercise drains muscle energy pools, contributing to muscle soreness, fatigue, loss of peak performance and even tissue damage. Ribose has been proven to accelerate tissue energy recovery and aid in restoring the physiological condition of muscle. That reduces cell damage and protects the heart and muscles from the rigors of strenuous exercise.
Scientific Rationale for the Nutritional Use of D-Ribose to Support Skeletal Muscle Health and Function [www.bioenergy.com]
[note the section marked **]
Conclusion
High-intensity exercise, muscle ischemia, or localized hypoxia overwhelms the cellular energy turnover mechanisms, oxidative phosphorylation, glycolysis, and the creatine kinase reaction. The resulting energy demand/supply mismatch leads to a cascade of reactions that drain purines from the cell and deplete the cellular energy, or adenylate, pool. This loss of energy substrates is a metabolic disaster to the cell because re-supply is slow and metabolically costly, and the resulting depletion in energy availability contributes to a variety of physiological conditions, including muscle stiffness, weakness, pain, cell damage, and depressed levels of protein synthesis.
D-Ribose stimulates the purine nucleotide pathway associated with salvage and de novo synthesis of purine nucleotides, reduces cellular purine loss, and accelerates energy recovery in the cell. Through this action, cellular energy charge is preserved and physiological consequences of depleted cellular energy are reduced.
Excerpts -
When muscles prepare to contract, calcium from the extracellular space and the sarcoplasmic reticulum rushes into the cytosol to form cross-links allowing the muscle to contract. Following contraction, this calcium must be physically pumped out of the cytosol. The calcium pumps function at high energetic cost because they are pumping calcium out of the cytoplasm against a concentration gradient of ~1:10,000. A disruption in calcium pump function retains calcium in the cytosol, having the effect of impairing muscle relaxation.
In hearts, this ultimately leads to diastolic dysfunction and angina, while in skeletal muscle it contributes to muscle stiffness, free radical formation, activation of proteases and phospholipases that attack structural proteins of the cell, and muscle pain known as delayed onset muscle soreness (DOMS) (Figure 2).
Any condition causing localized decrease in muscle oxygen tension has the effect of depleting the cellular energy pool. This reduction in energy status disrupts calcium management, creating muscle tension, stiffness, soreness, and fatigue. The increase in intracellular Ca++ causes a concomitant efflux of K+ that activates pain receptors on the cell membrane. Pain adds further to muscle tension, exacerbating the energy drain and continuing the cycle.
Chronic ischemia, hypoxia or repeated bouts of high-intensity exercise have the effect of driving purines out of the cell and lowering cellular energy charge (Figure 3). It is the frequency and severity of hypoxia that determines the rate and degree of energy depletion. In untrained subjects, a single bout of high-intensity exercise may be sufficient to drain energy reserves and contribute to muscle stiffness and soreness. However, in trained muscle repeated bouts of high-intensity exercise over several days may be required. In athletes energy depletion contributes to overtraining effect, causing muscle pain, weakness, and physiological damage to the muscle.
Free Energy of Hydrolysis of ATP Determines Functional Status of Muscle
The free energy of hydrolysis of ATP (ÄG~ATP) defines the energy status of the cell and describes the chemical driving force within the cell that is available to complete biochemical reactions. The ÄG~ATP is expressed as a negative number, meaning the hydrolysis of ATP is far from equilibrium and that hydrolysis of ATP to ADP + Pi contributes to an increase in entropy. Without getting into a discussion of the second law of thermodynamics, simply note that the less negative the ÄG~ATP becomes, the less chemical driving force there is in the cell. Therefore, if the cell has a high negative number it has more energy available to drive biochemical reactions through the ATPase enzymes involved in cell function.
Normal, healthy heart and muscle cells have ÄG~ATP of -56 kJ or greater (to a maximum of ~-70 kJ). As long as the free energy stays at or above -52 kJ the cell will have enough energy to drive all its biochemical reactions and will function normally.
**However 12 minutes of hypoxia are sufficient to drive the ÄG~ATP below -52 kJ, meaning the cellular calcium pumps will begin to fail. Prolonged pump failure contributes to diastolic cardiac dysfunction, skeletal muscle stiffness, weakness, and soreness and cell damage. Muscle contraction will continue to function normally.
**Continued energy drain will lower the free energy of hydrolysis further. Several more minutes of hypoxia will drive the ÄG~ATP below -48 kJ, at which time the cellular ion pumps fail. Now, cellular edema, cell leakage, and cell wall damage occurs. Further, the electrochemical gradient across the cell membrane can be disrupted. In hearts, this contributes to systolic cardiac dysfunction and arrhythmia.
12 minutes of zero flow ischemia depletes cellular energy to the point at which contractile mechanisms fail. Except for conditions of extreme anoxia and energy depletion contraction will continue and force development will be largely unaffected. Prolonged hypoxic exercise contributes to cell and muscle damage and delayed recovery, but has little impact on short-term force development.
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Gross, G, J Auchampac. Role of ATP dependent potassium channels in myocardial ischaemia. Cardiovasc Res 1992; 26:1011-1016.
Recently, a class of potassium (K) channels has been discovered which are regulated by the intracellular level of ATP. These channels have been termed ATP dependent K channels (KATP) and have been found to exist in the heart, skeletal muscle, pancreatic beta cells, brain, and smooth muscle. In this article, we discuss the function of the KATP channel in the ischaemic myocardium and present evidence to suggest that activation of these channels may, on one had result in a marked cardioprotective effect from reversible or irreversible electrical, functional or biochemical change, or on the other hand, have the potential to produce electrical instability and a proarrhythmic effect. The therapeutic potential of potassium channel modulators is also discussed.
The End
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