We all know how important mitochondria are.  They are the powerhouses of our cells and they are responsible for energy production and metabolic optimization.  The link between mitochondrial dysfunction and chronic disease is becoming stronger every day.  How many people do you know have some type of chronic disease such as diabetes, high blood pressure, fibromyalgia, chronic fatigue, thyroid disease, obesity, or others?  It’s everywhere and often a sign of underlying metabolic or mitochondrial dysfunction. 

Mitochondria are frequently negatively impacted by HPA (hypothalamic pituitary adrenal) axis and metabolic stressors, certain medications, and poor lifestyle habits.  Fortunately, these are the factors that we can fix or improve!

When we consider that some of the most mitochondrial-dense tissues in the body are the heart, liver and brain, we can see how many diseases of those tissues need mitochondrial support.  In addition to this, mitochondria have been implicated as key regulators of both innate and adaptive immune function through metabolic and cell-signaling mechanisms.  Therefore, knowing mitochondrial dysfunction plays a major role in chronic disease is important, but it’s just one piece of the puzzle.  The challenge is objectively measuring the health of the mitochondria.  Here are some clues to help you solve the puzzle of mitochondrial dysfunction.

Lab Markers for Mitochondrial Dysfunction

For good or bad, we cannot do a mitochondrial biopsy to assess mitochondria directly; the more practical option involves labs showing dysfunction or interruption in the ATP production process, like organic acid panels, or levels of oxidative damage, such as oxidative stress tests, lipid peroxides, glutathione levels, or 8-hydroxy-2’-deoxyguanosine (8-OHdG).   Many basic lab tests also show indications of oxidative stress.  For example, Hemoglobin A1C or oxidized LDL are labs commonly run for diagnoses such as diabetes or dyslipidemia, but these elevated markers are also indicators of increased reactive oxygen species (ROS).  Since mitochondria supply the body with its primary energy needs, when issues arise, patients often present with symptoms like fatigue, pain and accelerated aging.

Organic Acid Panels:  Organic acid panels are similar to an emissions test for your vehicle.  Just like an emissions test indicates how efficiently your engine burns fuel, organic acid panels indicate how efficiently mitochondria produce ATP.  Certain nutrients are necessary for the chemical reactions of metabolism, and when they are deficient, specific markers in the urine indicate where the deficiency is occurring.  If abnormalities are found on organic acid panels, the production of ATP is most likely incomplete, indicating the need for mitochondrial support.

Oxidative Stress Panels:  Oxidative stress panels evaluate antioxidant reserve availability, protective enzyme functionality, and the presence or absence of tissue damage.  Many clinicians recommend glutathione supplementation to support antioxidant capacity, but a full panel may also indicate the need to support precursors for glutathione production or cofactors needed for recycling capabilities of a redox reaction.  Abnormalities on oxidative stress panels are a strong indicator of reduced antioxidant capacity and need for mitochondrial support.

8-Hydroxy-2’-deoxyguanosine: 8-OHdG is a biomarker measured to assess the effect of endogenous oxidative damage to DNA.  It can be tested singularly or is included on some hormone panels and nutrient deficiency tests.  This marker is often used to estimate cancer and chronic disease risk and indicates antioxidant systems have failed and damage to lipids, proteins and DNA has occurred.  In nuclear and mitochondrial DNA, 8-OHdG is elevated due to free radical-induced lesions.  In patients with elevated 8-OHdG, it is imperative to not only find the source of damage, but also to provide support for antioxidant capacity.

Oxidized LDL: Strongly atherogenic, oxidized LDL particles (oxLDL) are indicators of damaged fats.  They are readily accumulated by macrophages/foam cells, and elevation in this marker indicates excessive oxidative damage.  This establishes the necessity for increased antioxidant capacity and mitochondrial support in these patients.

Subjective or Intake Indicators for Mitochondrial Support

When assessing a patient’s history and chief complaint, it is common for patients to complain of extreme fatigue, pain, abdominal distress, weight gain or weakness.  Often, they arrive with a prior or current chronic disease diagnosis like autoimmunity, metabolic syndrome, chronic fatigue syndrome, or fibromyalgia; these diagnoses indicate the need for mitochondrial support.

It may be apparent that patients are taking medications such as statins, steroids, or other medications (see some below), which have known mitochondrial toxicity.  If so, this indicates the need to consider recommending mitochondrial support nutrients.

Nutrient Support for Mitochondrial Health

Many nutrients and supplements have a powerful and positive impact on mitochondria and their ATP production.  There are specific nutrients shown to drive ATP production while also quenching the ROS produced as a byproduct.  

See the nutrient chart below for some examples.

Mitochondrial dysfunction has been identified in chronic disease and aging for many years.  However, making the connection clinically has been a somewhat slower adoption, as many test indicators are not routinely done with standard labs testing.  

Thanks to Ortho Molecular (whose products I recommend regularly) and to Angela Lucterhand, DC, for the bulk of the content on this article!

Check out my store to find many of these supplements, as well as my other blog posts on mitochondria and overall health optimization!

Live Great,
Dr. Eric