By Dr. John Neustadt

Mitochondria are the powerhouses of our cells. They create the cellular energy that allows us to think, move, eat, talk, breathe and everything else our bodies do. Along with creating energy as adenosine triphosphate (ATP), they also product heat.

The largest number of mitochondria is found in the most active cells, such as muscles (skeletal and heart), the liver and brain. Mitochondria are found in every human cell except mature red blood cells.

Mitochondria are found in every human cell except mature red blood cells (erythrocytes). Cellular energy requirements control how many mitochondria are in each cell. A single in the body can contain from as little as 16 mitochondria in sperm to as many as 100,000 in a woman’s egg (oocyte). In non-reproductive cells, there are anywhere from 200 to 2000 mitochondria.

DNA provides the biochemical blueprints for our cells to create proteins. While most DNA lives in the cell nucleus, mitochondria have their own DNA. The fact that mitochondria have their own DNA, along with comparative analyses of mitochondria DNA and DNA from other organisms, led scientists to conclude that mitochondria descended from bacteria that colonized an ancient cell between one and three billion years ago. The ability for cells to start producing their own cellular energy allowed for the evolution of multicellular organisms such as humans. The fact that mitochondria contain their own DNA is cited as evidence for the theory that mitochondria evolved from free-living bacteria.

Unlike nuclear DNA, mitochondrial DNA lacks an important protein called histones. Histones protect DNA free radical damage. Since mitochondrial DNA don’t have histones it is more susceptible to attack from free radicals, and it’s this free radical damage that’s is responsible for mitochondria’s role in creating disease.

The first mitochondrial disease was described in 1962, when a thirty-five-year-old woman experienced myopathy (muscle damage), excessive perspiration, heat intolerance (feeling hot when everyone else feels normal or cool), polydipsia (excessive thirst) with polyuria (excessive urination), and a metabolic rate 180% of normal. The patient suffered from mitochondrial damage that resulted in the generation of heat without creating energy, which is why she felt hot. When samples of her muscle were taken and examined under a microscope, numerous enlarged mitochondria were seen. Just like muscles, when mitochondria have to work more, they get bigger. In her case, in order to produce enough energy to simply satisfy the minimum requirements of her body, her mitochondria had to work extremely hard.

Since then, mitochondrial dysfunction has been implicated in nearly all diseases, including:

• Aging
• Alzheimer’s disease
• Anxiety disorders
• Bipolar disorder
• Cancer, including hepatitis-C virus-associated liver cancer
• Cardiovascular disease, including atherosclerosis (hardening of the arteries)
• Diabetes
• Exercise intolerance
• Fatigue, including chronic fatigue syndrome, fibromyalgia, and myofascial pain (pain arising from the connective tissue surrounding muscles)
• Huntington’s disease
• Nonalcoholic steatohepatitis (enlarged, fatty liver not caused by alcoholism)
• Parkinson’s disease
• Sarcopenia (weakness from muscle wasting)
• Schizophrenia

Damage to mitochondrial can create weakness, muscle cramping and pain, atypical migraines, failure to gain weight, respiratory problems, absent or excessive sweating, atypical cerebral palsy, and more. However, since symptoms vary from person to person, mitochondrial dysfunction may not be recognized early on. Symptoms such as fatigue, muscle pain, shortness of breath, and abdominal pain can easily be mistaken for other diseases, such as chronic fatigue syndrome, fibromyalgia, or psychosomatic illness (symptoms caused by psychological conditions). Additionally, most doctors don’t consider mitochondrial damage as a potential underlying cause of these symptoms.

Damage to mitochondria is caused primarily by free radicals, also called reactive oxygen species (ROS), that are generated by the mitochondria themselves during their production of cellular energy. The body maintains sophisticated antioxidant systems that can help neutralize free radicals. However, this system can be overwhelmed when there is an increase in free radical production or a decrease in antioxidants to deal with them.

Within the mitochondria, elements that are particularly vulnerable to free radical damage include fats, proteins, mitochondrial DNA and the enzymes used to create cellular energy. Direct damage can overwhelm their ability to fix the damage and decrease their ability to produce energy. Mitochondrial dysfunction can result in a feedforward process, whereby mitochondrial damage causes additional damage.

Medications Damage Mitochondria

Damage to mitochondria explains the side effects and dangers from pharmaceuticals. And when people take drug cocktails (multiple drugs simultaneously), they put themselves at even greater risk for mitochondrial damage. The FDA does not require that drugs be tested for their ability to damage mitochondria, which may occur slowly over time. There is a long list of medications that cause mitochondrial damage.

Alcoholism medications:

• Disulfiram (Antabuse)

Pain and anti-inflammatory medications:

• Aspirin
• Acetaminophen (Tylenol)
• Diclofenac (Voltaren, Voltarol, Diclon, Dicloflex Difen and Cataflam)
• Fenoprofen (Nalfon)
• Indomethacin (Indocin, Indocid, Indochron E-R, Indocin-SR)
• Naproxen (Aleve, Naprosyn)

Heart disease medictations:

• Angina medications: perhexiline, amiodarone (Cordarone), diethylaminoethoxyhexesterol (DEAEH)
• Antiarrhythmic (regulates heartbeat): amiodarone (Cordarone)
• Cholesterol medications:
  • Statins: atorvastatin (Lipitor, Torvast), fluvastatin (Lescol), lovastatin (Mevacor, Altocor), pitavastatin (Livalo, Pitava), pravastatin (Pravachol, Selektine, Lipostat), rosuvastatin (Crestor), simvastatin (Zocor, Lipex)
  • Bile acidsholestyramine (Questran), clofibrate (Atromid-S), ciprofibrate (Modalim), colestipol (Colestid), colesevelam (Welchol)

Anesthetics: bupivacaine, lidocaine, propofol

Antibiotics: tetracycline, antimycin A

Antidepressants: amitriptyline (Lentizol), amoxapine (Asendis), citalopram (Cipramil), fluoxetine (Prozac, Symbyax, Sarafem, Fontex, Foxetin, Ladose, Fluctin, Prodep, Fludac, Oxetin, Seronil, Lovan)

Antipsychotics: chlorpromazine, fluphenazine, haloperidol, risperidone, quetiapine, clozapine, olanzapine

Anxiety medications: alprazolam (Xanax), diazepam (Valium, Diastat)

Barbiturates: amobarbital (Amytal), aprobarbital, butabarbital, butalbital (Fiorinal), hexobarbital (Sombulex), methylphenobarbital (Mebaral), pentobarbital, methylphenobarbital (Mebaral), pentobarbital (Nembutal), phenobarbital (Luminal), primidone, propofol, secobarbital (Seconal, Talbutal), thiobarbital.

Cancer (chemotherapy) medications: mitomycin C, profiromycin, adriamycin (also called doxorubicin and hydroxydaunorubicin and included in the following chemotherapeutic regimens: ABVD, CHOP and FAC)

Dementia and memory medications: tacrine (Cognex), galantamine (Reminyl)

Diabetes medications: metformin (Fortamet, Glucophage, Glucophage XR, Riomet), troglitazone, rosiglitazone, buformin

HIV/AIDS medications: Atripla, Combivir, Emtriva, Epivir (abacavir sulfate), Epzicom, Hivid (ddc, zalcitabine), Retrovir (AZT, ZDV, zidovudine), Trizivir, Truvada, Videx (ddI, didanosine), Videx EC, Viread, Zerit (d4T, stavudine), Ziagen, Racivir

Epilepsy (seizure) medications: valproic acid (Depacon, Depakene, Depakene syrup, Depakote, Depakote ER, Depakote Sprinkle, Divalproex sodium)

Mood stabilizer: lithium

Parkinson’s disease medications: tolcapone (Tasmar ), entacapone (COMTan, also in the combination drug Stalevo)

Protecting and Repairing Mitochondria

Fortunately, over the last half century since the first mitochondrial disease was identified, researchers have not only better defined the molecular and cellular biology of mitochondria, they have also researched ways to protect and reverse mitochondrial damage.

Since the major reason for mitochondrial dysfunction is free-radical damage, it is not surprising that research has shown that antioxidants may help repair mitochondrial dysfunction. Dietary supplements are not the only potential strategy; diets rich in antioxidants may also help.

Many vitamins and minerals are required to create the mitochondria cellular machinery and energy. These include:

Vitamins: Biotin, CoQ10, B-complex vitamins, Vitamin C, Vitamin E

Minerals: Iron, Magnesium, Manganese, Selenium, Sulfur, Zinc, Copper

Amino Acids: L-Carnitine

Other nutrients: Alpha Lipoic Acid

While these nutrients are available in foods, dietary supplements may be necessary to supply the nutrients in adequate amounts for optimal mitochondrial function.

If you are taking a multiple vitamin and mineral dietary supplement, make sure it has the most-absorbable forms of nutrients. Dr. John Neustadt’s article, When it Comes to Dietary Supplements, it’s Buyer Beware can help you understand how what to look for on a multiple vitamin and mineral product label to make sure you’re getting your money’s worth.

Sone nutrients, like L-Carnitine and Alpha Lipoic Acid (ALA) aren’t typically found in a multiple vitamin and mineral dietary supplement. Research has shown that these two nutrients, when provided in adequate amounts can repair mitochondrial damage and improve energy production. To study whether or not declines in biochemical activity associated with aging are reversible, L-carnitine and Alpha Lipoic Acid—alone and in combination—were administered to rats. L-carnitine was supplemented at dosages of 300 mg to kg of body weight per day (mg/kg bw/day) and Alpha Lipoic Acid at 100 mg/kg bw/day.

At the beginning of the study, the old rats had only approximately one-third of the biochemical function as the young rats. After a month of taking the nutrients, however, biochemical function of the old rats improved about 150%. Only the rats who took both nutrients experienced the improvement. Taking either of the nutrients in isolation didn’t provide the benefit.

Mitochondria are the essential energy-producing part of our cells. Diseases and medications damage mitochondria, which can lead to a reduction in energy and the onset and progression of chronic, degenerative diseases. In essence, what is happening when mitochondria are damaged is that the body then begins to poison itself and cause its own deterioration. Fortunately, research shows that some nutrients can help reverse mitochondrial damage.

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