Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. In last week’s Note, I talked about Brain Energy and how mental illness is connected to your metabolism, specifically your mitochondrial metabolism. 

Mitochondria is a complex topic that most of us barely remember from high school, but because of its significance to our future health, I’m going to unpack what it is, what it does, and the common sense things you can do to keep it healthy. Welcome to Mitochondrial Health! 

Let’s dive in!


Mitochondria and Your Health 


As a review, I want to talk about mitochondrial function as it relates to energy. Remember, life is energy. A good doctor friend of mine gave me a book on mitochondria this past year called Mitochondria And The Future Of Medicine by Dr. Lee Know. While reading this book, I had to revisit the biochemistry I learned in college and medical school. FYI: It gets deep! 

It’s so important to understand the function of your mitochondria. What is mitochondria? Mitochondria are those tiny parts of each cell that are your energy factories. They act like a cellular digestive system that takes in the nutrients, breaks them down, and creates energy for the cell. All energy comes from these little powerhouses. Each cell contains hundreds to thousands of these mitochondria (number depending on the cell type). Note: Some cell types need more mitochondria, i.e., muscle, heart, brain. 

The most important job of the mitochondria is cellular respiration. It’s not the only job, but it is the most important. This means they break down food (nutrients) and combine it with oxygen to make energy. This is where it gets kind of complex. Remember the electron transport chain from biochemistry. The electron transport chain is where protons are moved across membranes, the central process of all life (the proton pump). This chain of events results in oxidative phosphorylation: adding a phosphate to ADP to create ATP (source of all energy and life).


Mitochondrial Theory of Aging 


After energy production, the next most critical function of your mitochondria is regulating cellular death. When cells become worn out or damaged by mutations (usually caused by toxins, inflammation, aging, and sometimes drugs, alcohol, etc.,) they are forced to commit cellular suicide. This is called apoptosis (programmed cellular death). Remember that. If the mechanisms regulating apoptosis fail (get out of control), some serious consequences can occur, i.e., CANCER. 

Of all the theories of aging that we study in functional medicine, to me the Mitochondrial Theory of Aging makes the most sense. The main point of this theory is that the mitochondria is the body’s main source of free radicals. Free radicals are oxygen containing molecules with an uneven number of electrons that can damage molecules. That’s called oxidation. That’s called oxidative stress. Think about rust. That’s oxidative stress! That’s aging! 

The mitochondria can repair the damaged molecules, but if it’s overwhelmed by free radicals their regular tasks are minimized (i.e., regenerating new cells and new forms of energy to keep the body functioning well). Bottom line, they can’t keep up if they’re overwhelmed. 

Free radicals are generated from: 

  • Immune cell activation 
  • Inflammation
  • Poor diet
  • Mental stress
  • Excessive exercise
  • Infections
  • Ischemia (not getting enough blood supply, i.e., heart attacks)
  • Cancer
  • Aging


Preventing Mitochondrial Dysfunction 


Yes, it’s possible to slow down the aging process, and delay (or prevent) diseases related to mitochondrial decay. BUT, it all depends on their redox state. Note: Redox medicine is a big thing, i.e., whether your redox state is oxidized with free radicals (BAD) or reduced (GOOD).

So, these mitochondria send out transcription factors, like NRF1 and NRF2, that stimulate expression of genes that protect the cell until more mitochondria can be generated. I know I’ve geeked out a bit, but I wanted to explain the conditions that mitochondrial dysfunction can cause, and how best to prevent it. That’s the whole point of this Note! Unless you understand the complexities, you’re not really going to be able to translate it into something useful. That’s what I’m here for! 

Health conditions linked to mitochondrial dysfunction: 

  • Heart disease: Angina, hypertension, congestive heart failure
  • Ischemia
  • Strokes
  • Neurodegenerative diseases: Parkinson’s, Alzheimer’s, ADHD, Depression
  • Diabetes
  • Chronic fatigue
  • Fibromyalgia
  • Hearing loss
  • Macular degeneration and Glaucoma 
  • Aging skin
  • Fertility
  • Cancer 

Cancer happens when a single cell becomes selfish. It escapes the body’s control, and multiplies, i.e., the way bacteria can multiply. Cancers are really the result of genetic mutations (with a few exceptions). Typically, a cell must accumulate 8-10 mutations in specific genes before it can transform into a malignant cell. Normally, defective cells (no longer working towards the greater good of the body) are eliminated by apoptosis, programmed cellular death. This requires ATP. So, if you’re overwhelming the mitochondria, you don’t have enough ATP to repair and regenerate. 

In 1930, a famous German scientist named Otto Warburg received the Nobel Prize for discovering that cancers resulted from an impaired cellular respiration, mitochondrial dysfunction. In other words, cancer is a metabolic disorder. I strongly believe that. 


Supplements For Mitochondrial Health 


So, how do you go about protecting your mitochondria? The first thing, of course, is lifestyle! I always talk about the five things that I emphasize in my practice: Nutrition (what you eat), Exercise, Stress Reduction, Sleep, and Hormone Balance. Remember, calorie restriction is the only proven thing to extend lifespan (the best being a very low carb diet combined with intermittent fasting). Note: Intermittent fasting is a great thing for almost every condition, because that’s when you get your cellular repair (regeneration). The first thing I would do if I had cancer (or Alzheimer’s) is go on a Keto Diet. There’s no doubt in my mind. 

How do we support our mitochondrial function? Supplements. There are some fantastic supplements for mitochondria. I’ve been taking them for years (and maybe you have, too!). Let’s go over the most important ones. 


Everybody thinks about CoQ10 when they think about mitochondria. It’s a potent antioxidant; a membrane stabilizer; a vital component of that all important electron transport chain. CoQ10 helps your mitochondria produce ATP. It also protects your heart, lowers your blood pressure, and prevents oxidation of LDL (bad cholesterol).

Statins deplete your CoQ10. Everybody that takes a statin should take CoQ10. It helps prevent a lot of the muscle aches, energy depletion, and other things statins can cause. Beta blockers also deplete CoQ10. 

CoQ10 protects your brain. You should use the form ubiquinol (it’s the better one). As for dosage, for people with no pre-existing health problems, I recommend 100mg. Take with food for better absorption. If you have cardiovascular disease, you can take anywhere from 200-600mg. For neurologic conditions, 600-3000mg. It’s perfectly safe. 

CoQ10 is essential. The only downside is that it can get kind of expensive if you take it regularly. Note: the only person I probably wouldn’t put on CoQ10 is somebody who was on Coumadin (Warfarin), the old timey blood thinner that we don’t use much any more. 


I take D-Ribose everyday. It’s a simple five carbon sugar that won’t raise your blood sugar. I give it to my two diabetic kids for energy everyday. It’s safe for diabetics. 

D-Ribose works by replenishing the purine pool. It is especially important for the heart. It wakes up dormant parts of your myocardium. D-Ribose is very underutilized in cardiology. PQQ and CoQ10 are also underutilized by cardiologists. Note: If I was having a heart attack, I would beg for D-Ribose, because it can wake up those parts of your heart that you think are dead. 

Think about D-Ribose. I use it in powder form every morning. It’s great for athletes and for people on the Ketogenic Diet. I take it before exercise. Recommended dosage: 3-5 grams a day. 


A good combination to go with CoQ10 is something called PQQ. In the Doctor Rogers’ Energy Formula, I combined PQQ and CoQ10 in one capsule. It’s actually cheaper than CoQ10 alone. PQQ is a cellular signaling vitamin that not only protects your mitochondria from oxidative damage, it actually stimulates the growth of new mitochondria. That’s a big deal! You can create new mitochondria! So, CoQ10 makes your mitochondria create more ATP, and PQQ makes your cells create more mitochondria. 

PQQ is very neuroprotective. It stimulates something called the Nerve Growth Factor (NGF), which is very important for your brain. 


Another really good supplement for mitochondrial health is L-Carnitine. It functions to transport long chain fatty acids. Note: Remember, glucose is not the ideal source of fuel for your body, fatty acids are! 

L-Carnitine is synthesized by the amino acid precursors, Lysine and Methionine. Dietary L-Carnitine mostly comes from eating an animal based diet, i.e., red meat, poultry, wild caught organic fish, and dairy. 

You would think that vegetarians and vegans would be very depleted in this, but actually they aren’t. The body is compensating by less urinary excretion. This is kind of a body protective mechanism. If you are tired, you may need to supplement. 

There’s some controversy about a marker called TMAO, but I’m becoming less concerned about the TMAO than I used to be. In the past, if your TMAO marker was high we would say to restrict red meat and eggs, because (a) of Choline and (b) L-Carnitine. But I’ve changed my mind on this a little bit. Again, base it on how you feel and how much energy you have. 


In my opinion, the most important of the minerals is Magnesium. It stabilizes your ATP and makes it usable by the body. The mitochondria actually stores our magnesium. Eighty percent  of the population is deficient in magnesium, which means almost everybody needs to supplement. 

Magnesium is very cardio protective. It helps prevent cardiac arrhythmias, helps your bowels, and helps your energy. Note: Take it at night, because it can also help you sleep. 

Alpha Lipoic Acid 

This antioxidant is targeted to the mitochondria. It’s tied into modulating the energy carrier NAD. Other helpful supplements for mitochondria: 

  • Creatine
  • B-Vitamins
  • Resveratrol 
  • CBD


Final Thoughts 


I can’t say enough how important it is to keep your mitochondria healthy. When you take it down to a cellular level, everything depends on it. If you’re tired, have cardiac or neurological issues, consider adding these supplements to your diet (in addition to the healthy lifestyle we always talk about). Note: If you continue to feel tired, you can work your dose up. These supplements are very safe. They are not going to hurt you. Let your own energy be your guide. 

Energy is life, and mitochondria is where it all starts. It not only gives you energy, it prevents the breakdown and oxidative stress that causes all these degenerative processes of aging and toxicity. The good news is that there are a whole host of things you can do to protect your mitochondria. Believe me, it will be worth it in the long run! 

Till next week.