Learn why I’ve been supplementing with d-ribose for fibromyalgia and chronic fatigue and how it can help to improve symptoms…
I have made a lot of progress over the past year in terms of improving my fibromyalgia symptoms. However, the symptom that still persists is chronic fatigue. Accompanying this delightful symptom is delayed onset fatigue (aka post-exertional malaise) and a general feeling of being unwell.
These symptoms vary in severity depending on how well (or not) I pace myself, which is the basis behind my reasoning to re-evaluate how I pace.
Although I have more energy compared to this time last year, it’s slow progress and I am still very limited in what I am able to achieve each day without causing an exacerbation of symptoms. I am really focusing my attention on fatigue now and this lead me towards researching a supplement called D-ribose to see if it could further improve my fibromyalgia and chronic fatigue.
Mitochondrial dysfunction in fibromyalgia & chronic fatigue syndrome
Within the cells of our bodies, there are structures known as mitochondria. The mitochondria are the energy powerhouses of the body; their job is to produce energy in the form of ATP (adenosine triphosphate). ATP is used for any process in the body that demands energy. It has been suggested in recent studies that mitochondrial dysfunction may play a role in fibromyalgia and chronic fatigue syndrome (CFS).
How the body creates energy
To understand this, we first need to gain a basic understanding of how the body uses ATP to create energy. ATP consists of one adenosine and three phosphate bonds. These phosphate bonds are high energy.
An enzyme called ATPase breaks the third phosphate bond of ATP, releasing a large amount of energy for the body to use. ATP then becomes ADP (adenosine diphosphate, which has two phosphate bonds).
Re-cycling ATP to create more energy
The body then needs to recycle ADP back to ATP to create more energy. ADP passes back into the mitochondria where a process called oxidative phosphorylation occurs– this basically means another phosphate group is stuck back on to transform ADP back into ATP.
This is normally a very efficient process and it is believed that a healthy person will recycle ADP every 10 seconds. The theory concerning mitochondrial dysfunction suggests that this recycling process is slow in people with fibromyalgia or CFS. If the cells are slow to recycle energy, the person goes slow– i.e. presents with poor stamina and fatigue.
An energy crisis in the body
The problem is further exacerbated when someone then pushes their body beyond their limitations (i.e. fails to pace themselves properly as most us do!). When you do this you are effectively demanding more energy than your body can supply.
Your body is converting ATP to ADP (to give you the energy you are demanding) faster than it can recycle ADP back to ATP. You end up with a build up of ADP and a lack of ATP. This is essentially an energy crisis in the body.
More worryingly, your body can then further break down ADP to AMP (adenosine monophosphate) in a bid to provide you with the energy you are demanding. The problem with this is that AMP, for the most part, is lost in the urine and is not recycled (any that is, is recycled very slowly).
The body then needs to create brand new ATP. This is a slow process and accounts for post-exertion malaise.
What is D-ribose?
This is where D-ribose comes in. The body can make ATP from a sugar called D-ribose but unfortunately, D-ribose is slowly made from glucose– a process that can take anywhere from one to four days and which can explain the biological basis for delayed fatigue.
There is a further complication, however. If the body is particularly short of ATP, it can make a small amount of ATP by converting glucose into lactic acid. This is called anaerobic metabolism and it is believed that this is what many sufferers do to meet energy demands. The problem with this is that lactic acid quickly builds up and causes muscle pain.
Additionally, due to this process, no glucose is leftover to make D-ribose (in order to create new ATP molecules). Therefore, when you really push yourself your body cannot easily make new ATP and recovery can take days. I think we can all relate to that feeling of hitting a wall and literally being left with no energy. This is why pacing is so important.
Supplementing with D-ribose to help improve fibromyalgia and chronic fatigue
Even if there is a supply of glucose present to create new ATP, this again is a very slow process. The thought behind supplementing with D-ribose is that this makes D-ribose immediately available to create new ATP. It cuts out the step where the body needs to make D-ribose from glucose and essentially helps with energy recovery.
One study of 257 patients treated with D-ribose had very promising results. Participants were given 5g of D-ribose three times daily. After three weeks, the following results were found:
- 61.3 % increase in energy
- 37% increase in overall well being
- 29.3% improvement in sleep
- 30% improvement in mental clarity
- 15.6% decrease in pain
Improvement began in the first week of treatment.
The participants of the study used a specific brand of D-ribose called Corvalen. It’s worth keeping in mind that not all supplements are created equally.
Side effects of D-ribose include nausea, stomach discomfort and diarrhoea. This is thought to be caused by fermenting gut. If you have any GI issues, I would suggest avoiding this supplement until those issues are resolved. It can also cause low blood sugar so not suitable for diabetics unless otherwise instructed by a doctor.
Although I haven’t gone into detail here, it is worth bearing in mind that there are other areas of mitochondrial metabolism that may need to be addressed, such as coenzyme Q10, L-carnitine, magnesium and antioxidant levels.
Finally, given all I have written above about energy production if you are not pacing yourself well, you may not see the best results (if any) from using this supplement.
My experience of D-ribose
Before I start, it is worth noting that for the past 10 months I have been taking the Vital Plan Restore program, which includes a supplement called Mitochondrial Support. Therefore it is unlikely to be D-ribose alone causing the below improvements, but rather a combination of all of these supplements.
I began taking D-ribose on the 29th of September. I bought this brand because it is about half the price of Corvalen (which I couldn’t afford due to the amount I already spend on supplements). I noticed a difference from the first dose. It made me feel more awake and alert.
However, I was finding the effects short-lived. I was taking 5g, 3 times daily as is often suggested. I was also finding that this dose was causing some mild bloating. I decided to experiment and began taking 2.5g, 6 times daily. This is a pain but easy enough to do given I’m always at home or at my mum’s. D-ribose is incredibly sweet but tolerable and I mix it into a tiny bit of fruit juice to take. I seem to tolerate the smaller dose well and taking D-ribose more frequently was when I really started to notice the effect it was having on me.
Pacing was an important factor
I decided to go back to basics with pacing, along with taking D-ribose. After just one week, I was beginning to have moments of feeling well at rest. My husband and mum have both noted that I seem to be doing better. Other improvements include:
- Less delayed fatigue (though keep in mind what I just said above about pacing)
- Reduced feeling of being unwell
- I feel I am getting better quality sleep some nights
- Improved mental clarity and concentration
- Reduced achiness
I think the improvements I have felt are great but I know if I push myself too much that I will still get a surge of increased symptoms. D-ribose is not a miracle cure. It is a useful supplement to aid your body’s recovery. I am going to continue taking D-ribose and it will be interesting to see if it helps me to progress any further in terms of my physical abilities.
You may have read that I also wanted to try a supplement acetyl-l-carnitine. Unfortunately, this supplement did not agree with me, causing an increase in fatigue, headaches and dizziness. I, therefore, stopped taking this supplement immediately. I just wanted to include this in case anyone was wondering why I haven’t written about it.
What are your thoughts? Does the theory of mitochondrial dysfunction make sense to you? Have you tried D-ribose? Let me know in the comments below.
Pin for later: