Fw: Update #27 - Exciting New CFS/Fibromyalgia Therapy!

[Guest guest]

I thought someone might be interested in trying this. Love, Anita Update #27 - Exciting New CFS/Fibromyalgia Therapy! D-Ribose- A very promising and safe new fibromyalgia/CFS treatment. Information and an invitation to be part of a study (very simple to do) Dear Readers, As part of our efforts to find new, safe, and effective CFS/Fibromyalgia treatments, we are trying a promising new over the counter nutrient, called D-Ribose (Corvalen), that works by directly increasing energy production (every where-including your muscles). A few of our patients found it to be wonderful for both pain and energy, so we are exploring it further by conducting a study on it. It is natural, quite safe, tastes good (sweet like sugar but healthy-comes as a powder) and very low in side effects. Rarely, it can cause a mild drop in blood sugar as it gets energy production moving. If you feel dizzy or hungry when you take it, simply take it with a meal or lower the dose. If you would like to try it, we are happy to supply you with a free bottle (which usually costs ~ $50) if you would like to be part of the study. All you would need to do is take it for ~ 3 weeks (till you finish the bottle) and fill out a simple 2 page questionnaire. If you would like to be part of the study, please respond to Angie at claims@... ASAP with your name, phone #, and address and that you agree to the qualifications below, as it will be limited to the first 40 people. We have ~ 17,000 newsletter subscriptions so we expect the study to fill quickly. We expect an overwhelming response Due to the fact that we are a very small offcie we will not ba able to send out rejection e-mails. If you have not heard from us within 1 week of the date of this e-mail you have not been selected for the study. If you would like to try the Corvalen, but not be in the study, it is also available on our web site shop ( www.vitality101.com ) for ~$50 . For more information, see a recent journal report at the end of this e-mail on the use of Ribose in a patient with Fibromyalgia. To be part of the study: 1-You need to be 18 years old or older. You need to have been given a diagnosis of CFS & /or fibromyalgia in the past by a practitioner and not have severe medication and nutrient sensitivities. 2- Take 1 level scoop 3 x day. It can be mixed with food, water, other beverages, etc. 3-Fill out the information on Page 1 of the questionnaire on the date you start the treatment and then fill out Part 2 when you are taking the last dose. 4-Stay on your current treatment(s), if any, and do not add any other new treatments or stop old ones while you are on the Ribose. It is helpful if you are on a B complex vitamin as well (you can start that now, or we can send you a free bottle of B-Complex to start a few days before the study if you request it). 5-Return the 2 page form and the ribose container in the postage prepaid envelope we’ll supply. To say thank you for being in the study and filling out the form, we’ll be happy to mail you another free container of Corvalen as well at that time. 6-If you have any questions, feel free to e-mail Angie (Claims@... ). Thank you for helping with the study. This is how we learn! Best wishes, Teitelbaum MD Research: Benefit of Ribose in a Patient With Fibromyalgia 01-31-2005 Journal: Pharmacotherapy Posted on MedScape 01/07/2005 Gebhart, Pharm.D.; A. nson, M.S., FASHP Abstract and Introduction Abstract Ribose was added to the existing treatment regimen of a woman with fibromyalgia, resulting in a decrease in symptoms. It has been postulated that patients with fibromyalgia may have an alteration in muscle adenine nucleotide metabolism, leading to depleted energy reserves and an imbalance in cellular adenosine-triphosphate:adenosine 5'-diphosphate:adenosine 5'-monophosphate (ATP:ADP:AMP) ratios with an abnormal energy charge. As a key component in adenine nucleotide synthesis, ribose supplementation may be useful in such patients. Introduction Fibromyalgia is a syndrome that is manifested by generalized muscle pain and additional systemic symptoms of fatigue, tenderness and stiffness in multiple joints, sleep disturbance, and alterations in bowel activity. The specific etiology is unknown; however, changes in muscle histology, energy metabolism, oxygen utilization, and the neuroendocrine stress-response system have been postulated to play a role in the development and persistence of this disorder. [1] Low levels of muscle adenine nucleotides, reflected in depleted energy reserves and an imbalance in cellular adenosine 5'-triphosphate:adenosine 5'-diphosphate:adenosine 5'-monophosphate (ATP:ADP:AMP) ratios with an abnormal energy charge, have been reported.[2-4] The unknown cause and varying presenting symptoms make fibromyalgia a therapeutic challenge for practitioners.[5-7] The management of patients with fibromyalgia requires the integration of both pharmacologic and nonpharmacologic approaches. Pharmacologic options have included tricyclic antidepressants, selective serotonin receptor antagonists, analgesics, benzodiazepines, antiinflammatory agents, and corticosteroids.[5, 6, 8] Routine daily exercise programs, dietary modifications, alternative therapies such as biofeedback and hypnotherapy, and nutraceuticals such as S-adenosyl-L-methionine (SAMe) have also been explored.[9] Unfortunately, less than 50% of patients achieve any meaningful relief of their symptoms with use of those therapies.[5] We describe the case of a patient with fibromyalgia who had symptomatic relief when ribose was added to her existing treatment regimen. There have been anecdotal reports on the benefits of ribose in patients with fibromyalgia in whom conventional therapies have failed; however, to our knowledge, this is the first published case of use of ribose for this syndrome. Case Report A 37-year-old woman had daily episodes of intense musculoskeletal pain and stiffness, mental "cloudiness," bouts of diarrhea, and sleep disturbance. As she was a surgeon, these symptoms compromised the skills necessary to perform her daily duties in the operating room. She was diagnosed with fibromyalgia by exclusion of other diseases and syndromes and in accordance with the American College of Rheumatology criteria.[10] The patient was treated with ibuprofen 800 mg twice/day, valdecoxib 10 mg once/day, diphenhydramine 50 mg-acetaminophen 1000 mg at bedtime, and physical therapy once/day. She stated that this therapeutic regimen had limited benefit and that the adverse effects from these drugs further impaired her ability to perform her operative duties. Approximately 7 months later, in addition to her regular drug therapy, the patient began taking CORvalen (Bioenergy, Inc., Ham Lake, MN), a ribose-based product. She took 5 g of CORvalen mixed in water twice/day. She experienced no adverse effects, and after 14 days she reported a decrease in her symptoms. Specifically, she noted an improvement in sleep, mental alertness, a marked decrease in joint pain, and normal stools. This trend continued, and after an additional month of CORvalen therapy she reported near-normal functioning with a major reduction in her symptoms. After another month of taking CORvalen and feeling "normal," the patient elected to discontinue the drug. Within 7 days, she regressed to her initial fibromyalgia state, as reflected in joint pain, sleep disturbance, morning stiffness, trigger-point flares, and diarrhea. She resumed taking CORvalen, at the same dosage as before, and a major reduction in her symptoms again occurred within 14 days. She noted continual benefit for the next month while taking CORvalen. She stopped taking the drug for a second time after this additional 30-day period, and once again she experienced a reemergence of symptoms. When CORvalen was restarted for a third time, the patient's symptoms again subsided. At the time of this writing, the patient was continuing to take CORvalen and was satisfied that her symptoms had abated. Discussion Ribose is a simple carbohydrate that plays a role in high-energy phosphate and nucleic acid synthesis. After ischemia or hypoxia, myocytes have decreased levels of ATP and total adenine nucleotides. Several days are required for their recovery once normoxia has been reestablished.[11-13] In patients with chronic hypoxic conditions, the cellular energy charge may never be fully regained.[14] These cells have the capacity to regenerate ATP; however, the pentose phosphate pathway of glucose metabolism utilized in the formation of the ribose that is needed to drive the regenerative process is slow in both heart and skeletal muscle cells due to poor expression of specific rate-limiting enzymes. Supplemental ribose has been shown to enhance the synthesis of adenine nucleotides, rebuilding depressed energy pools in both the heart and skeletal muscle after an ischemic or hypoxic insult.[11, 12] Ribose bypasses the rate-limiting enzymatic steps of the pentose phosphate pathway and accelerates the formation of ATP and subsequent tissue recovery.[15] Supplemental ribose is initially converted to ribose-5-phosphate, subsequently forming 5-phosphoribosyl-1-pyrophosphate, a molecule key to the synthesis of ATP through the de novo purine nucleotide pathway. The safety of ribose has been investigated in standard and animal toxicology models and in human studies both subjectively and objectively. Investigators have concluded that ribose is well tolerated at dosages of up to 60 g/day, with no significant adverse effects.[16] Ribose has been shown to improve the energy recovery time in skeletal muscle and to relieve fatigue, soreness, and stiffness after intense exercise.[12, 13, 17] It also has been reported to have a beneficial effect after high-intensity exercise in sports medicine. One study concluded that ribose accelerated the replenishment of ATP after intense muscle contractions,[18] and bodybuilders and sprinters have reported subjective and objective benefits during exercise after the administration of ribose.[18-20] However, other reports have shown inconsistent results for ribose in relation to improving short-term anaerobic exercise performance, muscle strength, endurance, or body composition during cycling or resistance training.[20, 21] Ribose has also been investigated for its potential medical efficacy in both animal studies and human clinical trials. To date, the most promising data have been reported in connection with the application of ribose in cardiovascular disease. Both short-term and long-term animal studies found that the use of ribose after myocardial ischemia resulted in enhanced recovery of ATP along with improved diastolic functional parameters.[22, 23] Clinical benefits have also been observed. Patients with coronary artery disease or heart failure have decreased myocardial ATP levels. Daily supplemental ribose has been shown to improve cardiac function, increase exercise tolerance, and enhance quality of life in this population.[24] Patients with fibromyalgia may experience an alteration in physiologic muscle metabolism. It has been found that they reach the anaerobic threshold in their muscles earlier, thereby using less of the available energy-rich phosphate metabolites at maximal work capacity.[25] In another study, patients with fibromyalgia were reported to have a potential abnormality in high-energy phosphate metabolism, as evidenced by significantly lower levels of ATP and ADP in affected muscles as compared with patients without the disease.[2] Theoretically, the effect of ribose on increasing the muscle energy pool could reduce the metabolic strain in affected muscles and allow patients to assume a more active lifestyle. Considering the known musculoskeletal symptomatology in this syndrome and the reported benefits of ribose in skeletal muscle metabolism and physiology, supplemental ribose appears to have aided our patient in improving her quality of life. Conclusion Fibromyalgia presents a continuing therapeutic challenge. Ribose is a naturally occurring carbohydrate with documented medical benefits in patients with cardiovascular disease. To our knowledge, this is the first report to suggest its potential benefit in a patient with fibromyalgia, who had had suboptimal results with conventional therapies. We are designing a trial using objective outcome measures to further evaluate the effectiveness of this product in patients with fibromyalgia Pharmacotherapy 24(11):1646-1648, 2004. © 2004 Pharmacotherapy Publications References: 1. Olson NJ, Park JH. Skeletal muscle abnormalities in patients with fibromyalgia. Am J Med Sci 1998;315:351-8. 2. Bengtsson A, Henriksson KG, Larsson J. Reduced high-energy phosphate levels in the painful muscles of patients with primary fibromyalgia. Arthritis Rheum 1986;29:817-21. 3. Eisinger J, Plantamura A, Ayavou T. Glycolysis abnormalities in fibromyalgia. J Am Coll Nutr 1994;13:144-8. 4. Park JH, Phothimat P, Oates CT, Hernaz-Schulman M, Olsen NJ. Use of P-31 magnetic resonance spectroscopy to detect metabolic abnormalities in muscles of patients with fibromyalgia. Arthritis Rheum 1998;41:406-13. 5. Leventhal LJ. Management of fibromyalgia. Ann Intern Med 1999;131:850-7. 6. Friedberg F, LA. Chronic fatigue syndrome and fibromyalgia: clinical assessment and treatment. J Clin Psychol 2001;57:433-55. Lash AA, Ehrlich- L, McCoy D. Fibromyalgia: evolving concepts and management in primary care settings. Medsurg Nurs 2003;12:145-59, 190. 7. Briley M, Moret C. Fibromyalgia syndrome: an overview of potential drug targets. Drugs 2003;6:668-73. 8. Holdcraft LC, Assefi N, Buchwald D. Complementary and alternative medicine in fibromyalgia and related syndromes. Best Pract Res Clin Rheumatol 2003;17:667-83. 9. Wolfe F, for the American College of Rheumatology. Criteria for the classification of fibromyalgia: report of the multi-center criteria committee. Arthritis Rheum 1990;33:160-72. 10. St Cyr J, Bianco R, Schneider J, et al. Enhanced high energy phosphate recovery with ribose infusion after global myocardial ischemia in a canine model. J Surg Res 1989;42:157-62. 11. Hellsten Y, Skadhauge L, Bangsbo J. Effect of ribose supplementation on resynthesis of adenine nucleotides after intense intermittent training in humans. Am J Physiol Integr Comp Physiol 2004;286:R182-8. 12. on DL, Gallagher PM, Goddard MP, Witter J, Trappe S. Effects of ribose supplementation on adenine nucleotide concentration in skeletal muscle following high-intensity exercise [abstr]. Med Sci Sport Exer 2001;33(5 suppl). 13. Ingwall JS. ATP and the heart. Boston: Kluwer Academic, 2002:55-95. 14. y DF, Pepine CJ. D-ribose as a supplement for cardiac energy metabolism. J Cardiovasc Pharmacol Ther 2000;5: 249-58. 15. Pliml W, von Arnim T, Stablein A, Hoffman H, Zimmer HG, Erdmann E. Effects of ribose on exercise-induced ischaemia in stable coronary artery disease. Lancet 1992;340:507-10. 16. T, St Cyr J. Use of ribose to prevent cramps and soreness in muscles. U.S. patent 6159943. December 12, 2000. 17. Zarzeczny R, Brault JJ, Abraham KA, Hancock C, Terjung R. Influence of ribose on adenine salvage after intense muscle contractions. J Appl Physiol 2001;91:1775-81. 18. Van Gammeren D, J, Falk D. The effects of four weeks of ribose supplementation on body composition and exercise performance in healthy, young, male recreational bodybuilders: a double-blind, placebo controlled trial. Cur Therapeut Res 2002;63:486-95. 19. Berandi JM, Ziegenfuss TN. Effects of ribose supplementation on repeated sprint performance in men. J Strength Cond Res 2003;17:47-52. 20. Falk DJ, Heelan KA, Thyfault JP, Koch AJ. Effects of effervescent creatine, ribose, and glutamine supplementation on muscular strength, muscular endurance, and body composition. J Strength Cond Res 2003;17:810-16. 21. Schneider J, St Cyr J, Mahoney J, Bianco R, Ring W, Foker J. Recovery of ATP and return of function after global ischemia [abstr]. Circulation 1985;72(4 pt 2):III-298. 22. Zimmer HG. Normalization of depressed heart function in rats by ribose. Science 1983;220:81-2. 23. Omran H, Illien S, Mac D, St Cyr J, Luderitz B. D-ribose improves diastolic function and quality of life in congestive heart failure patients: a prospective feasibility study. Eur J Heart Failure 2003;5:615-19. 24. Lund E, Kendall SA, Janerot-Sjoberg B, Bengtsson A. Muscle metabolism in fibromyalgia studied by P-31 magnetic r esonance spectroscopy during aerobic and anaerobic exercise. Scand J Rheumatol 2003;32:138-45. Source: MedScape

[Guest guest]

sounds interesting anita

thanks for the post. Maybe I will try it

Hugs, kathy

> I thought someone might be interested in trying this. Love, Anita

>

> Update #27 - Exciting New CFS/Fibromyalgia Therapy!

>

>

> D-Ribose- A very promising and safe new fibromyalgia/CFS

treatment.

> Information and an invitation to be part of a study (very simple

to do)

>

>

>

> Dear Readers,

>

> As part of our efforts to find new, safe, and effective

CFS/Fibromyalgia treatments, we are trying a promising new

> over the counter nutrient, called D-Ribose (Corvalen), that works

by directly increasing energy production (every

> where-including your muscles). A few of our patients found it to

be wonderful for both pain and energy, so we are

> exploring it further by conducting a study on it. It is natural,

quite safe, tastes good (sweet like sugar but healthy-comes

> as a powder) and very low in side effects. Rarely, it can cause a

mild drop in blood sugar as it gets energy production

> moving. If you feel dizzy or hungry when you take it, simply take

it with a meal or lower the dose. If you would like to try it,

> we are happy to supply you with a free bottle (which usually costs

~ $50) if you would like to be part of the study. All you

> would need to do is take it for ~ 3 weeks (till you finish the

bottle) and fill out a simple 2 page questionnaire. If you would

> like to be part of the study, please respond to Angie at

claims@e... ASAP with your name, phone #, and

> address and that you agree to the qualifications below, as it will

be limited to the first 40 people. We have ~ 17,000

> newsletter subscriptions so we expect the study to fill quickly.

We expect an overwhelming response. Due to

> the fact that we are a very small offcie we will not ba able to

send out rejection e-mails. If you have not heard from

> us within 1 week of the date of this e-mail you have not been

selected for the study. If you would like to try the Corvalen,

> but not be in the study, it is also available on our web site shop

( www.vitality101.com ) for ~$50 . For more information, see a

> recent journal report at the end of this e-mail on the use of

Ribose in a patient with Fibromyalgia.

>

>

> To be part of the study:

>

> 1-You need to be 18 years old or older. You need to have been

given a diagnosis of CFS & /or fibromyalgia in the past by a

> practitioner and not have severe medication and nutrient

sensitivities.

>

> 2- Take 1 level scoop 3 x day. It can be mixed with food, water,

other beverages, etc.

>

> 3-Fill out the information on Page 1 of the questionnaire on the

date you start the treatment and then fill out Part 2 when you

> are taking the last dose.

>

> 4-Stay on your current treatment(s), if any, and do not add any

other new treatments or stop old ones while you are on the Ribose.

> It is helpful if you are on a B complex vitamin as well (you can

start that now, or we can send you a free bottle of B-Complex to

start

> a few days before the study if you request it).

>

> 5-Return the 2 page form and the ribose container in the postage

prepaid envelope we’ll supply. To say thank you for being

> in the study and filling out the form, we’ll be happy to mail

you another free container of Corvalen as well at that time.

>

> 6-If you have any questions, feel free to e-mail Angie

(Claims@endfatiguecom ).

>

>

> Thank you for helping with the study. This is how we learn!

>

> Best wishes,

>

> Teitelbaum MD

>

>

> Research: Benefit of Ribose in a Patient With Fibromyalgia

>

>

> 01-31-2005 Journal: Pharmacotherapy

>

> Posted on MedScape 01/07/2005

>

> Gebhart, Pharm.D.; A. nson, M.S., FASHP

>

> Abstract and Introduction

>

> Abstract

>

> Ribose was added to the existing treatment regimen of a woman

with fibromyalgia, resulting in a decrease in symptoms.

> It has been postulated that patients with fibromyalgia may have an

alteration in muscle adenine nucleotide metabolism,

> leading to depleted energy reserves and an imbalance in cellular

adenosine-triphosphate:adenosine 5'-diphosphate:adenosine 5'-

monophosphate (ATP:ADP:AMP) ratios with an abnormal energy charge.

As a key component in adenine nucleotide synthesis,

> ribose supplementation may be useful in such patients.

>

> Introduction

>

> Fibromyalgia is a syndrome that is manifested by generalized

muscle pain and additional systemic symptoms of fatigue,

> tenderness and stiffness in multiple joints, sleep disturbance,

and alterations in bowel activity.

>

> The specific etiology is unknown; however, changes in muscle

histology, energy metabolism, oxygen utilization, and the

> neuroendocrine stress-response system have been postulated to play

a role in the development and persistence of this disorder.

> [1] Low levels of muscle adenine nucleotides, reflected in

depleted energy reserves and an imbalance in cellular adenosine 5'-

triphosphate:adenosine 5'-diphosphate:adenosine 5'-monophosphate

(ATP:ADP:AMP) ratios with an abnormal energy charge,

> have been reported.[2-4] The unknown cause and varying presenting

symptoms make fibromyalgia a therapeutic challenge for practitioners.

[5-7]

>

> The management of patients with fibromyalgia requires the

integration of both pharmacologic and nonpharmacologic

> approaches. Pharmacologic options have included tricyclic

antidepressants, selective serotonin receptor antagonists,

> analgesics, benzodiazepines, antiinflammatory agents, and

corticosteroids.[5, 6, 8]

>

> Routine daily exercise programs, dietary modifications,

alternative therapies such as biofeedback and hypnotherapy, and

> nutraceuticals such as S-adenosyl-L-methionine (SAMe) have also

been explored.[9] Unfortunately, less than 50% of patients

> achieve any meaningful relief of their symptoms with use of those

therapies.[5]

>

> We describe the case of a patient with fibromyalgia who had

symptomatic relief when ribose was added to her existing treatment

> regimen. There have been anecdotal reports on the benefits of

ribose in patients with fibromyalgia in whom conventional therapies

> have failed; however, to our knowledge, this is the first

published case of use of ribose for this syndrome.

>

> Case Report

>

> A 37-year-old woman had daily episodes of intense musculoskeletal

pain and stiffness, mental " cloudiness, " bouts of diarrhea,

> and sleep disturbance. As she was a surgeon, these symptoms

compromised the skills necessary to perform her daily duties in

> the operating room. She was diagnosed with fibromyalgia by

exclusion of other diseases and syndromes and in accordance with

> the American College of Rheumatology criteria.[10]

>

> The patient was treated with ibuprofen 800 mg twice/day,

valdecoxib 10 mg once/day, diphenhydramine 50 mg-acetaminophen

> 1000 mg at bedtime, and physical therapy once/day. She stated that

this therapeutic regimen had limited benefit and that the

> adverse effects from these drugs further impaired her ability to

perform her operative duties.

>

> Approximately 7 months later, in addition to her regular drug

therapy, the patient began taking CORvalen (Bioenergy, Inc., Ham

Lake,

> MN), a ribose-based product. She took 5 g of CORvalen mixed in

water twice/day. She experienced no adverse effects, and after 14

> days she reported a decrease in her symptoms. Specifically, she

noted an improvement in sleep, mental alertness, a marked decrease

> in joint pain, and normal stools. This trend continued, and after

an additional month of CORvalen therapy she reported near-normal

> functioning with a major reduction in her symptoms.

>

> After another month of taking CORvalen and feeling " normal, " the

patient elected to discontinue the drug. Within 7 days, she regressed

> to her initial fibromyalgia state, as reflected in joint pain,

sleep disturbance, morning stiffness, trigger-point flares, and

diarrhea. She

> resumed taking CORvalen, at the same dosage as before, and a major

reduction in her symptoms again occurred within 14 days. She

> noted continual benefit for the next month while taking CORvalen.

She stopped taking the drug for a second time after this additional

30-day period, and once again she experienced a reemergence of

symptoms. When CORvalen was restarted for a third time, the

patient's

> symptoms again subsided.

>

> At the time of this writing, the patient was continuing to take

CORvalen and was satisfied that her symptoms had abated.

>

> Discussion

>

> Ribose is a simple carbohydrate that plays a role in high-energy

phosphate and nucleic acid synthesis. After ischemia or hypoxia,

> myocytes have decreased levels of ATP and total adenine

nucleotides. Several days are required for their recovery once

normoxia

> has been reestablished.[11-13] In patients with chronic hypoxic

conditions, the cellular energy charge may never be fully regained.

[14]

>

> These cells have the capacity to regenerate ATP; however, the

pentose phosphate pathway of glucose metabolism utilized in the

> formation of the ribose that is needed to drive the regenerative

process is slow in both heart and skeletal muscle cells due to poor

> expression of specific rate-limiting enzymes. Supplemental ribose

has been shown to enhance the synthesis of adenine nucleotides,

> rebuilding depressed energy pools in both the heart and skeletal

muscle after an ischemic or hypoxic insult.[11, 12] Ribose bypasses

> the rate-limiting enzymatic steps of the pentose phosphate pathway

and accelerates the formation of ATP and subsequent tissue

> recovery.[15]

>

> Supplemental ribose is initially converted to ribose-5-phosphate,

subsequently forming 5-phosphoribosyl-1-pyrophosphate, a molecule

> key to the synthesis of ATP through the de novo purine nucleotide

pathway The safety of ribose has been investigated in standard

> and animal toxicology models and in human studies both

subjectively and objectively. Investigators have concluded that

ribose is well

> tolerated at dosages of up to 60 g/day, with no significant

adverse effects.[16]

>

> Ribose has been shown to improve the energy recovery time in

skeletal muscle and to relieve fatigue, soreness, and stiffness

after

> intense exercise.[12, 13, 17] It also has been reported to have a

beneficial effect after high-intensity exercise in sports medicine.

>

> One study concluded that ribose accelerated the replenishment of

ATP after intense muscle contractions,[18] and bodybuilders and

> sprinters have reported subjective and objective benefits during

exercise after the administration of ribose.[18-20] However, other

> reports have shown inconsistent results for ribose in relation to

improving short-term anaerobic exercise performance, muscle

strength, endurance, or body composition during cycling or

resistance training.[20, 21]

>

> Ribose has also been investigated for its potential medical

efficacy in both animal studies and human clinical trials. To date,

the most

> promising data have been reported in connection with the

application of ribose in cardiovascular disease. Both short-term and

long-term

> animal studies found that the use of ribose after myocardial

ischemia resulted in enhanced recovery of ATP along with improved

diastolic functional parameters.[22, 23]

>

> Clinical benefits have also been observed. Patients with coronary

artery disease or heart failure have decreased myocardial ATP

levels.

> Daily supplemental ribose has been shown to improve cardiac

function, increase exercise tolerance, and enhance quality of life

in this population.[24]

>

> Patients with fibromyalgia may experience an alteration in

physiologic muscle metabolism. It has been found that they reach

the

> anaerobic threshold in their muscles earlier, thereby using less

of the available energy-rich phosphate metabolites at maximal

> work capacity.[25] In another study, patients with fibromyalgia

were reported to have a potential abnormality in high-energy

phosphate metabolism, as evidenced by significantly lower levels of

ATP and ADP in affected muscles as compared with patients without

the

> disease.[2]

>

> Theoretically, the effect of ribose on increasing the muscle

energy pool could reduce the metabolic strain in affected muscles

and

> allow patients to assume a more active lifestyle. Considering the

known musculoskeletal symptomatology in this syndrome and the

> reported benefits of ribose in skeletal muscle metabolism and

physiology, supplemental ribose appears to have aided our patient

> in improving her quality of life.

>

> Conclusion

>

> Fibromyalgia presents a continuing therapeutic challenge. Ribose

is a naturally occurring carbohydrate with documented medical

> benefits in patients with cardiovascular disease. To our

knowledge, this is the first report to suggest its potential benefit

in a patient with fibromyalgia, who had had suboptimal results with

conventional therapies. We are designing a trial using objective

outcome measures

> to further evaluate the effectiveness of this product in patients

with fibromyalgia

>

> Pharmacotherapy 24(11):1646-1648, 2004. © 2004 Pharmacotherapy

Publications

>

> References:

>

> 1. Olson NJ, Park JH. Skeletal muscle abnormalities in patients

with fibromyalgia. Am J Med Sci 1998;315:351-8.

>

> 2. Bengtsson A, Henriksson KG, Larsson J. Reduced high-energy

phosphate levels in the painful muscles of patients with primary

> fibromyalgia. Arthritis Rheum 1986;29:817-21.

>

> 3. Eisinger J, Plantamura A, Ayavou T. Glycolysis abnormalities in

fibromyalgia. J Am Coll Nutr 1994;13:144-8.

>

> 4. Park JH, Phothimat P, Oates CT, Hernaz-Schulman M, Olsen NJ.

Use of P-31 magnetic resonance spectroscopy to detect

> metabolic abnormalities in muscles of patients with fibromyalgia.

Arthritis Rheum 1998;41:406-13.

>

> 5. Leventhal LJ. Management of fibromyalgia. Ann Intern Med

1999;131:850-7.

>

> 6. Friedberg F, LA. Chronic fatigue syndrome and

fibromyalgia: clinical assessment and treatment. J Clin Psychol

2001;57:433-55.

> Lash AA, Ehrlich- L, McCoy D. Fibromyalgia: evolving concepts

and management in primary care settings. Medsurg Nurs 2003;12:145-

59, 190.

>

> 7. Briley M, Moret C. Fibromyalgia syndrome: an overview of

potential drug targets. Drugs 2003;6:668-73.

>

> 8. Holdcraft LC, Assefi N, Buchwald D. Complementary and

alternative medicine in fibromyalgia and related syndromes. Best

Pract

> Res Clin Rheumatol 2003;17:667-83.

>

> 9. Wolfe F, for the American College of Rheumatology. Criteria for

the classification of fibromyalgia: report of the multi-center

> criteria committee. Arthritis Rheum 1990;33:160-72.

>

> 10. St Cyr J, Bianco R, Schneider J, et al. Enhanced high energy

phosphate recovery with ribose infusion after global myocardial

> ischemia in a canine model. J Surg Res 1989;42:157-62.

>

> 11. Hellsten Y, Skadhauge L, Bangsbo J. Effect of ribose

supplementation on resynthesis of adenine nucleotides after intense

> intermittent training in humans. Am J Physiol Integr Comp Physiol

2004;286:R182-8.

>

> 12. on DL, Gallagher PM, Goddard MP, Witter J, Trappe S.

Effects of ribose supplementation on adenine nucleotide

> concentration in skeletal muscle following high-intensity exercise

[abstr]. Med Sci Sport Exer 2001;33(5 suppl).

>

> 13. Ingwall JS. ATP and the heart. Boston: Kluwer Academic,

2002:55-95.

>

> 14. y DF, Pepine CJ. D-ribose as a supplement for cardiac

energy metabolism. J Cardiovasc Pharmacol Ther 2000;5: 249-58.

>

> 15. Pliml W, von Arnim T, Stablein A, Hoffman H, Zimmer HG,

Erdmann E. Effects of ribose on exercise-induced ischaemia in

> stable coronary artery disease. Lancet 1992;340:507-10.

>

> 16. T, St Cyr J. Use of ribose to prevent cramps and

soreness in muscles. U.S. patent 6159943. December 12, 2000.

>

> 17. Zarzeczny R, Brault JJ, Abraham KA, Hancock C, Terjung R.

Influence of ribose on adenine salvage after intense muscle

contractions. J Appl Physiol 2001;91:1775-81.

>

> 18. Van Gammeren D, J, Falk D. The effects of four weeks

of ribose supplementation on body composition and exercise

> performance in healthy, young, male recreational bodybuilders: a

double-blind, placebo controlled trial. Cur Therapeut Res

2002;63:486-95.

>

> 19. Berandi JM, Ziegenfuss TN. Effects of ribose supplementation

on repeated sprint performance in men. J Strength Cond Res

2003;17:47-52.

>

> 20. Falk DJ, Heelan KA, Thyfault JP, Koch AJ. Effects of

effervescent creatine, ribose, and glutamine supplementation on

muscular

> strength, muscular endurance, and body composition. J Strength

Cond Res 2003;17:810-16.

>

> 21. Schneider J, St Cyr J, Mahoney J, Bianco R, Ring W, Foker J.

Recovery of ATP and return of function after global ischemia

[abstr]. Circulation 1985;72(4 pt 2):III-298.

>

> 22. Zimmer HG. Normalization of depressed heart function in rats

by ribose. Science 1983;220:81-2.

>

> 23. Omran H, Illien S, Mac D, St Cyr J, Luderitz B. D-ribose

improves diastolic function and quality of life in congestive

> heart failure patients: a prospective feasibility study. Eur J

Heart Failure 2003;5:615-19.

>

> 24. Lund E, Kendall SA, Janerot-Sjoberg B, Bengtsson A. Muscle

metabolism in fibromyalgia studied by P-31 magnetic r

> esonance spectroscopy during aerobic and anaerobic exercise. Scand

J Rheumatol 2003;32:138-45.

>

> Source: MedScape