Help Your Patients Achieve Optimal Energy and Wellness

Fatigue is among the most frequent concerns reported by patients, often linked to deficiencies in nutrients like vitamin B₁₂, folate, vitamin D, or essential minerals such as iron, magnesium, and potassium. However, one of the most overlooked contributors to chronic fatigue is mitochondrial health.

Mitochondria, known as the “powerhouses of the cell,” produce ATP, the body’s primary energy source, and are central to maintaining cellular health and vitality. Factors such as heavy-metal exposure, viral infections like COVID-19, smoking, and lifestyle habits can compromise mitochondrial function, leading to fatigue, cognitive impairment, and even chronic illness.

By gaining a deeper understanding of how to support mitochondrial health, we can empower patients to improve their energy, resilience, and long-term well-being. With that said, let’s explore factors affecting mitochondrial function, the signs of dysfunction, and practical strategies to support these essential cellular engines.

Mitochondrial Function and Its Importance

Mitochondria are responsible for creating more than 90% of the energy cells need to survive and function. They play a role in cell signaling, growth, and death, all while managing oxidative stress within the cell. When they work efficiently, mitochondria contribute to robust cellular energy, a sharp mind, and resilience against infections and disease; as well as rapid recovery from injuries.

However, when mitochondria become dysfunctional, either from environmental factors or lifestyle habits, the body’s energy levels and ability to fend off illness are compromised.

Tests for Measuring Mitochondrial Function

The most common test among integrative practitioners is the “organic acids” (OA) test, which can be performed by a number of labs. OA tests can analyze more than 70 markers including mitochondrial function indicators like lactic acid and pyruvic acid, and can also identify gut microbial imbalances, vitamin deficiencies and even issues with detoxification which can impact mitochondrial health.

Physicians commonly use respirometry, which measures the rate of mitochondrial oxygen consumption, or muscle biopsies to measure “calcium retention capacity.” Bioluminescense can measure ATP production, which is an index of mitochondrial health. Glutathione levels and reactive oxygen species can assess mitochondrial damage.

Factors Affecting Mitochondrial Health

Lifestyle Habits: Poor lifestyle choices, particularly smoking, are among the most significant contributors to mitochondrial stress. Smoking introduces harmful substances like nicotine, carbon monoxide, cadmium, arsenic and lead that cause oxidative stress and damage mitochondrial DNA.

In the long term, this oxidative stress can lead to cellular dysfunction and increased risk for diseases such as cancer, cardiovascular issues, and neurodegenerative disorders.

Alcohol use also can negatively affect mitochondrial DNA, disrupt ATP production, increase oxidative stress and impair creation of new mitochondria.

Heavy-Metal Toxicity: Heavy metals like lead, cadmium, and mercury are particularly harmful to mitochondrial health. They disrupt mitochondrial enzymes, increase oxidative stress, and can impair ATP production. Mitochondria accumulate heavy metals over time, leading to gradual dysfunction. Heavy-metal toxicity is often linked to symptoms like chronic fatigue, cognitive decline, and mood issues.

Interestingly, heavy metals can accumulate in bones, liver, kidneys and other organs and tissues.

Environmental Pollutants: Beyond heavy metals, environmental pollutants like pesticides and plasticizers (e.g., Bisphenol A/BPA) can disrupt mitochondrial function. These chemicals affect mitochondrial DNA and interfere with the processes of energy production.

Diet and Nutritional Deficiencies: A lack of key nutrients such as CoQ₁₀, magnesium, and B vitamins can hinder mitochondrial efficiency. These nutrients are essential cofactors for the electron transport chain, the pathway by which mitochondria produce ATP. CoQ₁₀, for example, helps mitochondria create energy and is also a powerful antioxidant. Ubiquinol is the best form to recommend to your patients who are over 40.

High Stress Levels: Chronic stress elevates cortisol levels and places an additional burden on mitochondria by increasing the production of free radicals. When mitochondria are constantly forced to meet higher energy demands due to stress, they become more susceptible to oxidative damage, which can ultimately lead to mitochondrial dysfunction.

Aging: As we age, mitochondrial function naturally declines. The body’s ability to repair mitochondrial DNA diminishes, making mitochondria more susceptible to mutations and oxidative stress. While aging is inevitable, lifestyle interventions can slow down mitochondrial deterioration.

Signs and Symptoms of Mitochondrial Dysfunction

Poor mitochondrial health can manifest in various ways, such as:

• Fatigue and Low Energy Levels: Chronic, unexplained fatigue is one of the primary signs of mitochondrial dysfunction.
• Brain Fog and Cognitive Impairment: Mitochondria play a key role in maintaining brain function. When they are dysfunctional, cognitive clarity, memory, and focus may suffer.
• Muscle Weakness and Pain: Muscles are energy-intensive tissues. A lack of mitochondrial energy can lead to muscle cramps, weakness, and soreness.
• Mood Disorders: Mitochondrial dysfunction can contribute to symptoms of depression and anxiety, possibly due to impaired neurotransmitter production.
• Impaired Immunity: Mitochondria support the immune system, so dysfunction may lead to increased susceptibility to infections.

Strategies for Supporting Mitochondrial Health

Avoid Toxins and Quit Smoking: Reducing exposure to toxins such as cigarette smoke, heavy metals, and environmental pollutants is essential. Quitting smoking can vastly improve mitochondrial health by reducing oxidative stress. Limiting exposure to household toxins, such as BPA and cleaning agents containing phthalates, ammonia, bleach, perchloroethylene or formaldehyde, can also be beneficial.

Incorporate Antioxidant- and Polyphenol-Rich Foods: A diet rich in antioxidants can help counteract the oxidative stress that damages mitochondria. Organic foods like berries, leafy greens, nuts, and seeds contain compounds that neutralize free radicals. Additionally, supplements like CoQ₁₀, vitamin E, and vitamin C can help protect mitochondrial membranes from damage.

Address Nutritional Deficiencies: Certain nutrients are indispensable for mitochondrial function, including:

• Coenzyme Q₁₀ (CoQ₁₀)/Ubiquinol: Supports ATP production and acts as an antioxidant within mitochondria.
• Magnesium:: Essential for ATP synthesis and more than 400 enzymatic reactions in the body. Dosages of 200-400 mg daily in citrate, glycinate, or mixed salts. You can also recommend transdermal Mg chloride, which doesn’t cause loose stool/diarrhea.
• B Vitamins: Supplementing 50-100 mg of B₁ (thiamine) and B₂ (riboflavin) helps enhance cellular energy production, with 10-50 mg of B₃ (nicotinamide/niacin) and B₆ (pyridoxine) to support mitochondrial function.
• Nicotinamide Riboside: This B₃ derivative is getting a lot of attention in the anti-aging research community. It’s known to boost NAD+ levels; 300-500 mg per day is appropriate dosage, but you may want to start with lower dosages depending on tolerance. Some patients may complain of nausea, bloating, mild headaches or flushing.

Exercise Regularly: Exercise stimulates mitochondrial biogenesis, the process by which new mitochondria are created. Aerobic exercises like cycling, running, and swimming are especially effective at increasing mitochondrial capacity and efficiency. Resistance training also helps, although to a slightly lesser extent.

Manage Stress and Prioritize Sleep: Chronic stress and lack of sleep increase cortisol levels and oxidative stress, leading to mitochondrial damage. Incorporating stress management techniques, such as meditation or yoga, and ensuring proper sleep hygiene are both crucial for mitochondrial health.

Consider Detoxification for Heavy Metals: Chelation therapy or natural supplements like spirulina, broken cell chlorella, and alpha-lipoic acid may help with heavy-metal detoxification. This process can be valuable for individuals with known heavy-metal exposure, especially if experiencing symptoms of toxicity. (Higher toxicity levels may require multiple IV chelation sessions.)

Don’t Forget Acupuncture: Acupuncture can benefit mitochondrial health by supporting circulation, reducing inflammation, and relieving stress.

Supporting mitochondrial health is essential for maintaining energy, resilience, and overall wellness. By addressing lifestyle factors, reducing exposure to toxins, and ensuring optimal nutrition, we can help preserve mitochondrial function and protect against fatigue and other symptoms of mitochondrial dysfunction.

Integrating practices such as antioxidant-rich diets, regular exercise, and stress management can further promote mitochondrial efficiency, contributing to sustained energy and cellular health of our patients.

Resources

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