The M+G+R Foundation

Chronic Fatigue Syndrome

Understanding Its Mechanism


The Role That D-Ribose Plays In Its Cure


The primary purpose of this brief note is our attempt to present the mechanism that leads to Chronic Fatigue Syndrome, and its possible causes, in an easily to read and understand format.(0)
One of the principal causes of Chronic Fatigue Syndrome is the poor functioning of the human organism at the cellular level [see below about the mitochondrial function]. Nutrition plays a critical role in maintaining healthy body starting at the cellular level, and numerous physiological deficiencies [the processing of nutrients] may contribute to the poor functioning of the human cells, thus, the overall body.

The secondary purpose of this brief note is to assist those interested in understanding why D-Ribose is considered as a key (quasi magic) solution of Chronic Fatigue Syndrome, while, at the same time, help illustrate why, in some cases, it does not work as expected.


Chronic Fatigue Syndrome (CFS)

Chronic fatigue syndrome (CFS) is the most common name given to a variable debilitating disorder or disorders generally defined by persistent fatigue unrelated to exertion, not substantially relieved by rest and accompanied by the presence of other specific symptoms for a minimum of six months. (1) AMP, ADP and ATP

Since those acronyms must be used to discuss CFS it will be best if we clearly define them first.

AMP- Adenosine Mono phosphate
ADP - Adenosine Di phosphate ; and
ATP - Adenosine Tri phosphate

The only difference is the number of phosphate (PO4) groups in the Adenosine chain.

ATP has a chain of three phosphates (PO4) which are unstable. The removal of the third phosphate triggers the release of usable-by-the-body energy. Everything that a cell does uses up ATP, which, in the process, turns into ADP, which, in turn, and has to be re-generated back into ATP. The vast majority of ATP regeneration process happens in the mitochondria.

Adenosine, the root molecule to which the phosphate groups (PO4) are attached, is composed of the base adenine and the sugar D-Ribose.


In cell biology, a mitochondrion (plural mitochondria) is a membrane-enclosed organelle found in most eukaryotic cells (2). Mitochondria are where oxygen and food are converted to energy. However, they serve secondary functions as well.

For instance, when a cell is badly damaged, the mitochondria release certain signals that trigger the death of the cell. Mitochondria are inherited from the mother, so different maternal lineage have different mitochondria. Some are more efficient than others, and people with less efficient mitochondria have to learn what nutrients work best for them, and make sure they have enough of them.

In plain English: A mitochondrion is like a mini-cell inside every human cell which plays a key role in the restoration of the ATP once the usable-by-the-cell energy has been generated. It is also very complex, and must be properly maintained. (3)

The Process

It can be simplified as such:
Stored energy + ATP => Usable energy for a bodily process + ADP

+ Oxygen and Fuel (within the mitochondria) => ATP + inert by products

An Emergency Process

[The reader may scroll down to The Dysfunction and skip the following technical discussion without losing the thread of the message.]

If ATP resources, for whatever reason, are converted too far into ADP so that too little ATP remains available, some ATP can be generated from the excess ADP by transferring one phosphate (PO4) from one ADP molecule to another.


Remember "D" of "ADP" means two (PO4); "T" of "ATP" means three (PO4) and "M" of "AMP" means one, therefore what the above equation represents is:

(PO4)(PO4) + (PO4)(PO4) => (PO4)(PO4)(PO4) + (PO4)

No (PO4) lost or gained - just rearranged among the molecules.

AMP can be regenerated back to ATP but it is mostly lost. Therefore the AMP to ATP emergency process results in depletion of the root molecule Adenosine from the cellular pool.

The cell can generate new Adenosine to increase the ADP/ATP inventory in the cell, but it does so very slowly because its key raw material is D-Ribose and the body can only produce D-Ribose from glucose very, very slowly.

The Dysfunction

Technically, the Chronic Fatigue Syndrome is caused by the inability of the body to change stored energy into energy usable by the body. Using a very easy to understand parallel: The engine of an automobile cannot move the auto even if the fuel tank is full if it cannot convert the stored energy (gas in the tank) into usable energy (motion).

Applying some basic logic, the CFS could be caused, among other reasons, by:

Poor Mitochondrial function, so ATP is not generated at a sufficient pace to support an energetic person's activity:

i. Insufficiency of certain vitamins or minerals required for proper mitochondrial function

ii. Genetically inherited mitochondrial weakness (which may or may not be addressed by supplementing a key factor).

iii. Toxic exposure that has damaged mitochondria, in which case recovery may be slow (and may be improved with proper nutrition)

iv. ATP/ADP pools in the cell have been depleted for some known or unknown reason, and there is just not enough adenosine to regenerate them. Remember, D-Ribose is a component of Adenosine, and is produced by the body only slowly.


As it has aptly expressed (4d): Because everyone with CFS is different, we all have a different disease so to speak, some have more toxic damage, some have more stress related adrenal damage, some have more immune system damage, and some have more central nervous system or cognitive dysfunction.

Damages due to natural human responses, primarily stress, have a "responsible chemical" which may negatively affect the human cells. Every human emotion has a chemical consequence/reponse, for example - the immediate discharge of adrenaline into the bloodstream in a moment of fight or flight. However, if that same life saving adrenaline is kept at a higher than normal level in our system due to psychological disorders, it will stress our bodies, thus our cells, the mitochondria in particular.

Even love triggers chemical reactions throughout the human body which affect many of its parts - brain included.

Proper nutrition is very important to keep the mitochondria healthy, and with them, our cells well supplied with energy, which keeps the body healthy overall. Unfortunately, and generally speaking, we do not eat well, and this can sometimes lead to the problems listed above.

Individuals should strive first to eat well, but secondly, they should also experiment with simple supplements to see which ones restore our energy best. D-Ribose is one such candidate. (4)

(0) Unfortunately, most of the documents that we have reviewed on this subject matter - even those authored by professionals - were presented in an obtuse and incomplete manner [included some of those we cite in the footnote no. 4]. Thus, our desire to simplify and professionally explain what we cover in this document for the benefit of all - without the intent of selling a dietetic supplement or impress anyone with undefined and unnecessary "fancy words".
(1) Official Definition
(2) About Mitochondria
(3) Keeping Mitochondria in Good Working Order
A good, balanced diet is key to good health, you have always been told. That is indeed true, and a big part of the reason is that mitochondria require a lot of different nutrients to properly process store energy and turn it into usable energy.
"Burning calories" (oxidizing the food) is more than just a figure of speech. The whole process is a controlled fire, which cannot get out of hand or the cell dies. For instance, many of the B-vitamins are important for the proper functioning of the cells, and some people will find that supplemental B-vitamins are enough to keep their energy levels up, that is, keep "the fire going on a controlled fashion".
One factor that has gained a lot of attention is D-Ribose, which is the focus here.
(4) Other documents reviewed [Please Note: We neither endorse nor recommend the products marketed directly or indirectly in any of the following addresses. We are merely providing a list of documents from which we acquired some information regarding CFS and/or D-Ribose.]
(a) D-Ribose from Doctor Myhill
(b) Excerpts from "From Fatigued to Fantastic" by Jacob Tietelbaum, M.D.
(c) D-Ribose - Energizer and Fatigue Fighting Supplement
(d) How to recover from CFS : Mitochondria, CFS, and the Healing Lifestyle

Published on September 29, 2010, in Honor of the Great Archangels Michael, Gabriel and Raphael - European Union

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