Saul Marcus, ND - Naturopathic Doctor

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Mitochondrial Poisoning and Chronic Fatigue

This is a simple introduction into the topic of mitochondria function, ATP, energy production and supplementation.

ATP (adenosine triphosphate) is what our cells use for energy. It's a molecule made up of 3 parts; adenosine, ribose and phosphate. The phosphate bonds contain a lot of energy.

When the bonds to one of the phosphates is broken, adenosine triphosphate is transformed into adenosine diphosphate. The energy from the phosphate bond is released which powers many biochemical processes. Without ATP our cells don't have the energy to do what they need to do. We thus feel tired and sick.

Some specific things that ATP gives energy for:

In summation we take the energy from the food we eat, and burn it for fuel. That energy goes into the production of ATP, which is then sent where needed to power biochemical processes.

convertion of ATP into ADP for energy

Mtiochondria are tiny organelles that live inside out cells. This is where ATP is produced. Therefore for us to feel and be healthy, we need healthy and abundant mitochondria.

Image of mitochondria

Toxicity, and mitochondrial poisoning

Various health issues that can interfere with mitochondrial function:

Treating low energy

Although there are some specific supplments to help mitochondria function, a truly holistic treatment should go beyond this. All factors that impaire energy prodution need to be considered. Ignoring overall health and just taking some supplements for energy is putting a bandaid over the real problem. And often this is a bandaid that will not even work that well.

In practice, the author recommends using mitochondria supplements in a supportive role. If someone is feeling tired because of chronic infections, yeast/candida, toxicity and/or hormonal issues, then supporing energy production may help them feel better fast.

Considerations should include dietary changes, supplements (for underlining health issues) and exercise. Detoxification, or removing other roadblocks to health is also important. Whether or not people realize it not, much of what they do for health directly impacts mitochondria and ATP production

Since the factors that may impair ATP production are so varied, the best approach is to go through a case and treat the individual. Even if the treatment is not something that is typically thought of as for energy production, if it is moving someone towards health, it will help. If there is reason to believer the immune system is comprised or there is a significant toxicity issues it's essential treat those problems.

There is one "functional lab" test ( organic acid) that can test mitochondria activity. This may help with supplementation but is not something the author of this article typically has clients do. This is almost always an out of pocket expense and doesn't necessarily show what the cause of poor energy production is, even if it can demonstrate that this is happening on a lab test. It is often more helpful to take a careful history and try working on underlining issues.

Top supplements for mitochondria

The following is a list of some common supplements used for energy production. While these may have a place in treating people with fatigue issues, it can not be over stated that simply taking supplements for energy is no substitute for treating the whole person.

Coenzyme Q10
Inside of our cells, electrons have to be transported into mitochondria. Then through a series of biochemical reactions know as the "electron transport chain" the electron is used to convert ADP into ATP. CoQ10 is used to shuttle electrons through this process. Without enough of it electrons can not be moved through the mitochondria to produce energy. CoQ10 thus is an important supplement for cells that need to produce a lot of energy, particularly the heart.

Cells may use different sources of fuel to burn (or catabolize) for energy. Heart and skeletal muscle cells rely on fat. The brain relies on sugar. For cells that rely on burning fat carnitine is essential for transporting fatty acids into mitochondria. L-carnitine is a common supplement often used to help the cardiovascular system, athletic performance and fat burning.

Acetyl L-carnitine is a diffrent form that is more specific for brain and nervous system function.

PQQ (pyrroloquinoline quinone)
A vitamin like nutrient founds in foods such as parsley, green tea, green peppers, kiwi and papaya. It is a strong anti-oxidant. Rather than simply helping mitochondria function better, it helps stimulate the growth of new mitochondria. More mitochondria means we can make more ATP.

Resveratrol is a strong anti-oxidant found in red wine. It is commonly used as a supplement for it's "anti-aging" effect. In more recent years it has been studied for it's ability to stimulate growth of new mitochondria.

D-ribose is an needed building block to make ATP (see diagrams above). The body can synthesize d-ribose from sugar, but the process is slow. Another method if recycling d-ribose from metabolites of old ATP. Supplementing with d-ribose gives the body additional substrate to produce ATP. D-ribose is commonly used to support the cardiovascular system and athletic performance.

Curcumin and Tumeric
Tumeric is an herb which in recent years has become popular for many illnesses associated with inflammation. Research has been showing that in addition to anti-inflammatory activity, it is also helpful in mitochondria production and biogenesis. [4]

B vitamins and Minerals
Energy production depends on two biochemical processes. The Electron Transport Chain which is how ATP is make in mitochondrial. The "krebs" or Citric Acid Cycle is a series of reactions that produces substrates for energy production. The biochemistry of these processes is complex. What's important to know is that B vitamins and minerals are needed to drive many of these chemical reactions.

image of citric acid cycle

Medium chain triglycerides (MCT) from coconut oil
Coconut and palm oil contain high amounts of Medium Chain Triglycerides which effect health different than other fats. These fats are easily absorbed into the body and supply energy for mitochondria. Typically for mitochondria to convert fat into energy L-carnitine is needed to shuttle it across membranes. MCT's don't require carnitine. Additionally, MCT's are also converted into ketones, which can be used to supply energy for the brain.


  1. Mohsin Khan, Gulam Hussain Syed, Seong-Jun Kim, Aleem Siddiqui, Mitochondrial dynamics and viral infections: A close nexus, In Biochimica et Biophysica Acta (BBA) - Molecular Cell Research, Volume 1853, Issue 10, Part B, 2015, Pages 2822-2833, ISSN 0167-4889, ( Keywords: Mitophagy; Mitochondrial fission and fusion; Innate immunity; Virus; Hepatitis virus
  3. Mol Nutr Food Res. 2008 Jul;52(7):780-8. doi: 10.1002/mnfr.200700075. Medication-induced mitochondrial damage and disease. Neustadt J1, Pieczenik SR.
  4. Curcumin, mitochondrial biogenesis, and mitophagy: Exploring recent data and indicating future needs. de Oliveira MR, Jardim FR, Setzer WN, Nabavi SM, Nabavi SF. Biotechnol Adv. 2016 Sep-Oct;34(5):813-826. doi: 10.1016/j.biotechadv.2016.04.004. Epub 2016 May 1. Review. PMID: 27143655