Life Extension Magazine October 2012
Restoring Cellular Energy Metabolism
By Kirk Stokel
Energy is our most precious resource. With age, both our physical and cellular energy levels decline.1 Not only do we feel tired, but our cells become fatigued and fail to optimally function.
Additionally, our heart muscle weakens and does not contract as fully, often leading to congestive heart failure.2 D-ribose can help replenish the metabolic energy needed by all our cells, including those in major organs such as our heart and brain.3-5 The result? Increased vitality, along with improved cardiac and neurological function.
Ribose serves a number of other key processes in the body. Long chains of d-ribose are strung together to form ribonucleic acid or RNA, the DNA-like structures essential to copying our genes and translating them into functioning proteins.6 D-ribose provides antioxidant protection for body tissues.7 Even the immune system needs d-ribose to power its response to infection.8
In this article, you'll learn how d-ribose supplementation can assure that vital body processes aren't starved of essential energy molecules.
Broad Cardiovascular Support
Cardiovascular disease has multiple and interlinked causes.9 That's why no single drug or therapy can ever fully prevent or repair, cardiovascular damage.
It's also the reason that, generally, heart patients are on multiple medications—to deal with the complexity of their disease.
Supplemental d-ribose is an excellent candidate as a cardioprotectant, because it serves multiple targets. It provides defense against heart disease along the entire continuum of events that can lead to cardiac catastrophe.
D-ribose powerfully protects heart tissue against ischemia-reperfusion injury. This is the serious damage that occurs in the minutes to hours following a heart attack or stroke, when oxygen-starved (ischemic) tissue is suddenly flooded with oxygen-rich blood as circulation is restored (reperfusion).10 The sudden availability of oxygen in already-damaged tissue sets off a deadly chain of events, culminating in release of free oxygen radicals and harmful inflammatory responses.
But if high levels of ribose are made available before and immediately after the reperfusion occurs, most of those dangerous changes can be prevented, largely through ribose's actions on inflammatory blood cells.11 This effect is so potent that some forward-looking anesthesiologists and surgeons have suggested using IV infusions of ribose during surgical procedures in which ischemia-reperfusion injury is common.12
Ischemia, however, is not always an acute event with immediate consequences. Much more commonly, low-level ischemia occurs on a continuing basis in people with advancing coronary artery disease, gradually producing symptoms such as angina (chest pain) with exertion. As ischemia worsens, the pain can occur even while the patient is at rest.
Each episode of angina represents steady depletion of cellular energy levels, with loss of the energy molecule, ATP from heart muscle cells.13,14 This uses up the heart's normal supply of d-ribose. Under these circumstances, d-ribose becomes a conditionally essential nutrient.15
Continued long enough, this cellular energy starvation is a major contributor to congestive heart failure (CHF), in which heart muscle can't "squeeze" hard enough to move blood efficiently.16 The result is that fluid accumulates in tissues throughout the body as a result of poor cardiac "squeeze" (technically called contractility). The end result is progressive exercise intolerance, increasing difficulty breathing, and fluid retention. In the extreme, congestive heart failure can result in the deadly accumulation of fluid in the lungs—known as pulmonary edema—that is the ultimate cause of death for many victims of heart disease.
Many people with congestive heart failure find themselves on multiple medications aimed at reducing fluid accumulation or chemically increasing the heart's contractility. While these drugs can have some success, none are curative, and most have substantial side effects that can limit their utility.
Fortunately, congestive heart failure can be partially reversed, more readily if it is detected and treated early.
Increasingly, scientists are investigating the ischemia-energy relationship that links the severity of heart muscle damage to the supply of energy-mediating nutrients such as d-ribose.17-19
A noted cardiologist and author Stephen T. Sinatra, MD, who has written extensively on the cardiac benefits of d-ribose, recently stated, "Many physicians are not trained to look at heart disease in terms of cellular biochemistry…."19 But the growing interest in this field over the past decade opens the door to safer and much more effective therapy with cardiac energy preparations based on d-ribose, providing metabolic support for ailing heart muscle.13
The benefits of d-ribose began to interest researchers in the early 1990s. Those early studies were mainly focused on d-ribose as an aid in radiology techniques such as thallium scanning, which indicate areas of ischemia in the heart. Researchers found that by infusing d-ribose intravenously during the scan, they could see many more areas of heart muscle—because much more blood was permeating those tissues!6,20
Too often, individuals with coronary disease have limited mobility or are unable to engage in moderate exercise due to such limitations as lack of energy. German researchers found that they could use d-ribose to increase exercise tolerance in people with severe coronary artery disease and chronic ischemia.10 They gave patients an oral dose of 60 grams daily in four divided doses for just 3 days to achieve gains in endurance.
More recently, a different German group showed that d-ribose could improve heart function, as seen on echocardiograms, while also improving quality of life in patients with congestive heart failure.21
Through the recovery of ATP energy molecules and an increase in the heart muscle's energy levels, d-ribose improves heart muscle contractility—the "squeeze" needed to pump blood efficiently to the lungs and the body in general.22,23
When d-ribose was given intravenously to patients who have suffered one or more heart attacks, scientists found that the d-ribose increased the number of heart segments with good contractility, a visible marker of improved function.24
D-ribose's replenishment of heart muscle energy levels has additional benefits, as was shown in a recent study of patients with advanced congestive heart failure and extreme exercise intolerance.25 Researchers gave these patients d-ribose at 15 grams a day in three doses. The patients all had impressive improvement in their ability to breathe and ventilate their lungs, and a 44% improvement in their heart failure classification! These changes were significant, because they meant that this group of severely impaired patients could move about more freely and with increased comfort.
D-ribose has unique protective effects specific to brain cells.
In a recent study, cardiologists revealed that d-ribose not only improves heart function and blood flow—but also has a profound impact on brain tissue during the period of low blood pressure that can follow a heart attack.23 D-ribose reduced expression of a protein that triggers cell death in brain cells deprived of blood flow. This can also be a life-saving defense in the case of a stroke.23
The neuroprotective effect of d-ribose has major implications, because heart attacks and strokes contribute enormously to the age-related cognitive decline that is so prevalent today.
The neuroprotective benefits of ribose may spring partly from the antioxidant effects it provides throughout the body.7,26 But it is ribose's remarkable ability to restore energy-depleted tissues back to near-normal that is generating enthusiasm among scientists.
Supplementation with d-ribose increases the available amounts of ATP in brain tissue, just as it does in heart muscle.27 This is important, because the brain uses an enormous proportion of our total energy resources.