Clinical Updates:Restoring Health by Improving Mitochrondria Function
by Dr. Greg Fors, DC – Board Certified Neurologist DIBCN
What if the muscle and brain cells of your patients were unable to produce sufficient levels of cellular ATP to handle their active and even stressful lifestyles? How would they feel? Muscle cells without adequate ATP become tender, achy and weak. It actually takes more ATP to relax muscle cells than it does to contract them. Therefore, when energy is insufficient, muscles become a mass of painful tight knots, unable to let go. These myofascial trigger points keep firing into the central nervous system leading to a chronic pain state.
What happens to the brain of an individual who develops reactive hypoglycemia? They commonly experience fatigue, brain fog and headache. The brain needs a constant supply of glucose and oxygen to continually produce the massive amounts of ATP needed to generate thoughts and feelings. The brain is only 2% of our total body weight but utilizes more than 20% of the available oxygen and 25% of the calories consumed; all for energy production.
Research is now demonstrating that disorders such as neuropathic pain, migraine headaches, fibromyalgia, depression, anxiety, chronic fatigue and even neuro-degeneration all commonly share the lack of optimal cellular energy production.(1) Recent studies now support the fact that mitochondrial dysfunction is a primary cause of many mental health disorders, including depression.(2) A 2009 study found a direct connection between mitochondrial dysfunction and chronic fatigue syndrome.(3) How can this be?
The Power Plants of Your Cells
At the center of every cell are hundreds of throbbing engines cranking out massive amounts of ATP for everything your patient does; the much unappreciated mitochondria. These organelles have been called the power plants of your cells. The citric acid cycle of the mitochondria take Acetyl CoA manufactured from carbohydrates, fats and proteins, and converts it into NADH and FADH2 to be oxidized in cellular respiration to 32 molecules of ATP. When mitochondria are efficiently humming along, like well-tuned engines, your patient has all the energy they need. When the mitochondria are not working efficiently, this process slows down and health issues occur. Pieczenik and Neustadt’s recent study found a wide range of unrelated disorders tied to mitochondrial dysfunction. They stated in this study that, “Physicians seeking systematic treatments for their patients might consider testing urinary organic acids to determine how best to treat them”.(4) A test that I find vital for many patient’s recovery!
Just like a car engine will have abnormalities in the exhaust if the engine isn’t running efficiently, the cells produce metabolites that can be measured in the urine that can indicate when cellular metabolism is not working efficiently. More than that, this test can give you some idea of why the patient’s mitochondria are not working efficiently and what is needed to fix it. For example, it is not uncommon to find elevations of Adipic acid and/or Suberic Acid in the urine of patients with fibromyalgia and chronic fatigue. When these urinary metabolic acids are elevated it means that fatty acids are not efficiently being utilized for energy in the mitochondria. An elevation of Succinic acid is a marker for a deficiency of CoQ10 and Vitamin B-2 leading to inadequate cellular ATP production.
Medically it is well recognized that there are specific genetic defects that can render the mitochondria quite dysfunctional manifesting as crippling metabolic diseases. The problem is that our mitochondria are not like a simple on-off switch, either working perfectly or turned off. What is underappreciated by the public and clinicians is that the mitochondria can decline in their efficiency and lead to many of today’s most common disorders, from chronic muscle pain to depression and even degenerative diseases.
In fact, in a recent 2008 study the prestigious researchers Neustadt and Pieczenik went as far as to state the following: “Damage to mitochondria is now understood. to play a role in the pathogenesis of a wide range of seemingly unrelated disorders such as schizophrenia, bipolar disease, dementia, Alzheimer’s disease, epilepsy, migraine headaches, strokes, neuropathic pain, Parkinson’s disease, ataxia, transient ischemic attack, cardiomyopathy, coronary artery disease, chronic fatigue syndrome, fibromyalgia, retinitis pigmentosa, diabetes, hepatitis C and primary biliary cirrhosis. Medications have now emerged as a major cause of mitochondrial damage, which may explain many adverse effects. All classes of psychotropic drugs have been documented to damage mitochondria, as have statin medications, analgesics such as acetaminophen, and many others”.(5) This means drugs to treat depression and anxiety, or psychotropic drugs, can damage mitochondrial function and decrease cellular energy production.
Ready to Face Today’s Metabolic Challenges
Beyond the natural aging process, one of the primary ways mitochondria become inefficient is by depriving them of the necessary nutrients and the proper fuel they need to do their work. With this very common dietary scenario, muscle cells can become painful, tender and exhausted, and the brain becomes sluggish and depressed. Mitochondria need specific nutrients such as B vitamins, magnesium, zinc and iron to process calories into usable energy or ATP. When your patient eats a diet filled with empty calories they literally deplete the stores of necessary nutrients the mitochondria need to function properly. This again can be diagnosed when specific metabolites are elevated in a urinary organic acid profile.
Along with medications, toxic chemicals in our environment have been proven to cause mitochondrial injury and dysfunction. These industrial chemicals and pesticides cause damaging free radicals that disrupt the energy producing process of the mitochondria. This cumulative free radical damage to the cells is called oxidative stress. Elevations of lipid peroxides in the urine are a direct indicator of oxidative damage to the cell membranes. Also, elevation of a urinary metabolite called 8-OHdG indicates actual damage to cellular DNA from oxidative stress.
Why does damage to mitochondria lead to so many chronic and degenerative diseases? When the mitochondria become damaged they can actually work against themselves and cause damage to surrounding mitochondria and other cell organelles. It is actually the mitochondria that decide whether cells such as your neurons live or if enough damage is done they will signal the cell that it’s time to die. This is one way that we lose brain cells over the years; this can show-up as a mood disorder, and eventually manifest as Alzheimer’s disease or dementia. Therefore, you can see how vital it is as a clinician to provide your patients with the nutrients they need to protect the mitochondria from the damaging effects of chemicals in our environment.
The Cellular 3R Program……Remove, Restore and Repair
How does one go about diagnosing and treating this loss of cellular vitality through mitochondrial decline? This can be accomplished by becoming knowledgeable in the utilization of nutrition based on specific functional laboratory tests that require blood, urine and stool. These tests may include urinary organic acid profile, oxidative stress panel, plasma amino acids and essential fatty acid profile. These are tests that assist you in effectively treating the underlying causes of the wide variety of disorders from Fibromyalgia, chronic fatigue and depression to Autism and ADHD.
Once the key metabolic factors causing mitochondrial dysfunction have been identified through a proper diagnostic workup, an effective patient specific biomedical program must be commenced to normalize function. Utilizing a 3R program, Remove, Restore and Repair, factors damaging mitochondria must be Removed, based on metabolic needs, nutrient levels must be Restored and cellular and mitochondrial damage must be Repaired. With this 3R program, your patients are able to return to a life without pain and depression and without relying on drugs to get them through their day. For an in-depth discussion on this all important subject, see my book “Why We Hurt”, specifically chapters 5 and 17.
A couple of the products that have been specifically designed for this Cellular 3R Program include BIOSPEC’s Mito-Detox and Fibro-Ease. Mito-Detox is designed specifically to support and protect mitochondrial function and cellular detoxification pathways. Fibro-Ease is focused on providing specific nutrients for the mitochondrial citric acid cycle.