There's a growing awareness that a long lifespan isn't what most people truly want; rather, a long healthspan - meaning staying capable of living healthy, active lives while aging - is the penultimate goal. Currently, roughly 20% of the average person's lifespan is spent in ill health due to chronic disease, and mitochondria may be important pieces of how to improve these statistics. Mitochondrial dysfunction has been linked to most chronic illnesses, including diabetes, accelerated aging, neurodegenerative disorders, obesity, and cancer.  

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What Are Mitochondria?

Mitochondria are parts of your cells that play an important role in generating energy to run metabolism from the carbohydrates and fatty acids you eat and store. These organelles contain their own DNA, which is inherited maternally. Mitochondria are surrounded by a double membrane with an intermembrane space and an interior compartment where the mitochondrial DNA is stored. Mitochondria also regulate important processes such as cell survival and calcium homeostasis, and they are often misregulated in chronic disease, making them an important target for longevity research.  

The inner membrane of mitochondria houses an important set of proteins called the electron transport chain, where the breakdown products of carbohydrates and fatty acids are converted into ATP, the major source of energy for various metabolic reactions in the body. Through a process called oxidative phosphorylation, mitochondria generate ATP by utilizing the energy from the food we eat that is released via digestion. Your mitochondria create approximately your body weight in ATP each day!

Inherited disorders of mitochondria can cause severe metabolic problems leading to reduced ability to function or even death. However, these disorders are quite rare, and the more common relationship between mitochondria and overall health has to do with more subtle mitochondrial dysfunction that can play a role in chronic conditions such as insulin resistance, premature cellular aging, obesity, and Type II Diabetes.  

Why Should We Care About Mitochondria?

Shifting the focus to mitochondrial health may be a game-changer when it comes to seeking optimal health and longevity. When mitochondria aren't working well, the resulting loss of function can lead to excess fatigue and other symptoms that are common complaints in most chronic diseases. Since healthy mitochondria are needed to create ATP, any reductions in their function means less ATP available to provide energy for important metabolic reactions - leaving an individual feeling tired and not at their best.

Mitochondrial dysfunction has been linked to various chronic illnesses, including chronic fatigue syndrome and neurodegenerative diseases such as Alzheimer's, Parkinson's, and Huntington's disease. Since mitochondria play an important role in programmed cell death, or apoptosis, it's theorized that unhealthy mitochondria can't regulate cell death of errant cells as well in these conditions. Poor mitochondrial health has also been found to accelerate insulin resistance and the progression of metabolic syndrome due to the increased oxidative stress and inflammation that can build up when mitochondria are not performing well.  

Mitochondria also play an important role in the aging process, contributing to processes such as cellular senescence, chronic inflammation, and the natural decline in stem cell activity that accompanies aging. Strategies that are aimed at improving mitochondrial quality, function, and biogenesis may have far-reaching effects on longevity and on healthspan if we can keep our mitochondria healthier for longer. 

Functional Medicine Labs That Can Help Individualize Treatment for Mitochondrial Support 

When it comes to supporting mitochondrial function, several laboratory tests can provide valuable insights into the health and efficiency of these essential cellular powerhouses. These tests can help identify potential imbalances, deficiencies, or dysfunction within the mitochondria. Here are some examples of laboratory tests that support mitochondrial function:

Organic Acid Test

Organic acid testing (OAT) helps assess nutritional deficiencies that can impact a person's metabolic pathways, including energy production in the mitochondria. Organic acids are cellular byproducts produced through regular metabolic pathways that are required for survival, like energy production, protein and fat metabolism, and detoxification. The OAT has been shown in clinical studies to be an effective mitochondrial evaluation as part of an overall approach to mitochondrial disease.  

CoQ10 Levels

CoQ10 is an important component of the electron transport chain within mitochondria. Inadequate CoQ10 levels can compromise the efficiency of energy production, leading to fatigue and other symptoms. Additionally, decreased CoQ10 levels can lead to increased oxidative stress in the cells since CoQ10 plays an important antioxidant role. Serum evaluation of CoQ10 can help determine if your levels are adequate.

Carnitine Levels

Carnitine is a compound that's important for transporting fatty acids into the cell in order to be used for energy. Low carnitine may lead to issues with utilizing fats for fuel through oxidative phosphorylation in the mitochondria, showing up as symptoms like fatigue, hypoglycemia, steatosis, and even cardiomyopathy.  

Oxidative Stress Markers

Mitochondrial DNA is a vulnerable target of oxidative stress when inflammation is high in the body. Once mitochondria are damaged, oxidative stress is further amplified as the damaged mtDNA can no longer effectively produce the proteins that compose the electron transport chain. If this process continues unchecked, mitochondria will undergo cell apoptosis and die, leading to symptoms of poor mitochondrial function such as metabolic dysfunction, fatigue, and others. Checking oxidative stress markers can help guide a functional medicine approach to supporting healthy mitochondria.  

Fatty Acid Profile

A fatty acid profile is used to assess the balance between essential and non-essential fatty acids that are important for optimal metabolic health while also providing useful information on the ratio of omega-6 and omega-3 fatty acids, which can indicate overall inflammation. The mitochondrial membranes are made of these fatty acids, and composition can change with levels of various fatty acids. The function of mitochondria may be impacted by non-optimal levels of fatty acids, making it important to keep an eye on these biomarkers. For example, excessive omega-6 content may impair the function of the lipid membrane, affecting how glucose and fatty acids are transported to be used to make ATP within the mitochondria.  

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Supporting Mitochondria Through Functional Medicine Strategies

A functional medicine approach can be used to support healthy mitochondria. Below are some common functional medicine strategies:

Nutrition For Mitochondrial Health

A nutrient-dense, anti-inflammatory nutritional approach is essential for optimal mitochondrial health and function. Creating ATP for energy is a metabolically demanding process that requires a variety of vitamins, minerals, and other nutrients to run efficiently. The Mediterranean-type diet is one such approach that has been found to limit oxidative stress and ameliorate damage to the mitochondria, making it a smart choice to support mitochondrial health.  

Including foods and nutrients that help prevent oxidative damage are particularly important, such as antioxidants found in brightly colored fruits and vegetables and various herbs and spices, as well as foods rich in omega-3 fats such as coldwater fish and flaxseed.  

Additionally, vitamins and minerals like vitamin C, zinc, magnesium, CoQ10, carnitine, creatine, and B vitamins are needed for optimal mitochondrial health. 

Optimizing Mitochondrial Function With Supplements And Herbs

Below are some supplements that can help with mitochondrial optimization:

CoQ10

CoQ10 supplementation may be linked with alleviating inflammation and oxidative stress while decreasing symptoms of aging by impacting mitochondrial energy production.  

Dose: 100mg 3 times per day

Duration: At least 8 weeks

Pyrroloquinoline Quinone (PQQ)

PQQ appears to impact mitochondrial biogenesis by increasing key regulators of the energy production pathways in mitochondria. It may be a helpful antioxidant to improve overall mitochondrial health and efficiency as part of an overall healthy lifestyle.  

Dose: 20mg daily

Duration: 6 weeks

Omega-3 Fatty Acids

Omega-3 fish oil supplementation has been linked to improving the health of mitochondrial membranes while reducing reactive oxygen species characteristic of oxidative stress.

Dose: 2g EPA, 1g DHA

Duration: 12 Weeks

Alpha-Lipoic Acid

ALA is an antioxidant molecule that is involved in breaking down carbohydrates for energy in the mitochondria. Although, to date, there have been no controlled clinical trials done on ALA for mitochondrial disorders, the Mitochondrial Medicine Society (MMS) recommends ALA supplementation, and no safety issues have been documented.

Dose: up to 600mg/day

Duration: 6 months 

Carnitine

Carnitine is involved in the transportation of long-chain fatty acids into the mitochondria to create ATP. It also supports the removal of toxic metabolites from the mitochondria.

Dose: less than 2g/day in short duration

Lifestyle Modifications For Mitochondrial Health

One of the best lifestyle tools to improve mitochondrial health is regular physical activity and exercise. Exercise has been found to strongly induce PGC1-alpha, a compound that activates mitochondrial biogenesis and improves energy production. It should be noted that this is based on training intensity. While any form of movement is better than no movement, working in some higher-intensity exercise is going to make the biggest difference in getting the beneficial effects of improved mitochondrial biogenesis. 

Getting great sleep and sticking to a regular sleep routine is important for mitochondrial health as well since mitochondrial function is linked to the circadian rhythm (our sleep-wake cycle). A lack of sleep can negatively impact how well the mitochondria can work. Sleep is an important time for the body to "clear out" older, damaged mitochondria and turn over new mitochondria for optimal energy production.  

Managing stress levels is also important for mitochondrial health. When under stress, mitochondria can actually swell, leading to impairments in transport across the membranes and in the function of the electron transport chain - meaning they can't produce energy as well. Mitochondria are responsible for meeting the large energy demands of a prolonged stress response, meaning that poorly managed stress may place such a demand on the mitochondria that it can become difficult for mitochondria to maintain homeostasis and effectively do their job.

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Summary

Mitochondria are small cellular organelles that play a massively important role in how your metabolism runs efficiently, how you produce energy, and how you meet the demands you place on your body day in and day out. A functional medicine approach to supporting mitochondria may include functional medicine labs to assess underlying contributors to poor mitochondrial function, nutritional interventions, supplementation, and lifestyle strategies like optimizing sleep and stress management. The healthier your mitochondria are, the more likely you are to experience optimal health and well-being.