Can D-Ribose Create Advanced Glycation End Products (AGEs)?

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Generally yes, but apparently only at artificially high doses, not at the thereapeutic doses recommended by health care professionals for various disease conditions.

Ribose is a pentose monosaccharide (simple sugar) with the molecular form of H−(C=O)−(CHOH)4−H.  It is commonly known as its enantiomer as D-Ribose.

The main source of energy for all cellular processes is a molecule known as ATP (adenosine triphosphate). Under healthy conditions, the cells constantly replenish their supply of ATP.  However, under conditions of stress, injury, or aging, critical body tissues such as heart and skeletal muscles cannot produce ATP quickly enough to perform optimally.

D-ribose, a carbohydrate molecule found in every living organism, facilitates the production of ATP.

D-Ribose has been shown to be effective in a number of disease conditions, including:

  • improve symptoms of chronic fatigue syndrome (CFS)
  • improve symptoms of fibromyalgia
  • improve symptoms of coronary artery disease; D-ribose enhances the recovery of myocardial ATP, which improves overall cardiac function
  • improve athletic performance and the ability to exercise by boosting muscle energy

D-Ribose is treated differently by the body than regular hexose monosaccharides, such as, glucose, sucrose or fructose.  The body preserves D-Ribose for the production of ATP that provides the power to operate the heart, brain, muscles and other tissues.

Using D-Ribose as a treatment for the above-referenced conditions is based on the dosing regimen based on the needs of the person and the condition.  Health care professionals with experience using D-Ribose usually follow these dosing regimens:  1

    • Healthy individuals who want cardiovascular protection and greater comfort following strenuous activity – 5 gram/day
    • Athletes working out in chronic bouts of high-intensity exercise – 10-15 gram/day
    • Patients with mild-to-moderate heart failure, other forms of ischemic cardiovascular disease, or peripheral vascular disease – 10-15 gram/day
    • Individuals recovering from heart surgery or heart attack, for treatment of stable angina – 10-15 gram/day
    • Patients with advanced heart failure, dilated cardiomyopathy, individuals awaiting heart transplant, or people with frequent angina – 15-30 gram/day
    • People with fibromyalgia or neuromuscular disease – 15-30 gram/day

    It is usually recommended to divide the total daily dose into multiple 5-gram individual doses, instead of taking the entire dose at once.  The lowest dose per day is 5 grams and the highest does per day is 30 grams.  One case study from 1992 used 60 grams per day as four divided doses of 15 grams each for a human trial on exercise tolerance in people with coronary artery disease.  2  

    Since D-Ribose is a sugar, the question arises whether it can contribute to the development of harmful and tissue damaging advanced glycation end products (AGEs).

    AGEs are proteins or lipids that become glycated through a process called cross-linking as a result of exposure to sugars in the body.  The formation and accumulation of AGEs has been implicated in the progression of age-related diseases, such as:

    • Alzheimer’s Disease
    • cardiovascular disease
    • stroke

    When D-Ribose is the sugar in the glycation process, as opposed to glucose or fructose, it is called ribosylation. D-ribose is active in glycation and induces protein aggregation, rapidly producing AGEs in vitro and in vivo.  3  Recent studies indicate that ribosylation is a rapid process that causes protein aggregation in vitro and in vivo.  4

    Administration of high doses of D-ribose also accelerated AGE formation in the mouse brain and induced impairment of spatial learning and memory ability according to the performance in the Morris water maze test.  5

    All the referenced studies demonstrated that D-Ribose can cause protein glycation (ribosylation), when D-Ribose is administered in high doses, with resulting damage to tissues.

    The doses in these studies and experiments where intentionally high artificial doses and concentrations of ribose that are not even close to the therapeutic levels and doses recommended by health care professionals, which is from 5 grams per day to as high as 60 grams per day.  6 

    The therapeutic dosage range simply cannot cause serum ribose concentrations to rise high enough to create ribosylation that was found in the laboratory studies.

    To further reduce the risk of ribosylation using D-Ribose, health care professionals recommend that the total amount of the daily dosage be split into three (3) daily doses.  This assures that the D-Ribose serum remains at a safe level.