Chronic Fatigue and the Mitochondria

Overwhelming chronic fatigue is one of the biggest complaint’s patients have when they seek care from a Functional Medicine provider. The fatigue is not just bothersome — it can be so debilitating that it keeps people from completing even small everyday tasks. People with chronic fatigue are often told that the condition is in their head: they’re depressed, or that they are just plain lazy. Doctors frequently prescribe more exercise to boost energy levels — a recommendation impossible to implement if you are struggling just to get through the day.

What we have recently learned is that, for many people, chronic fatigue isn’t in their head. It results from a dysfunction deep in their cells. If you suffer from relentless fatigue, know that it’s not a lack of motivation but possibly poor production energy at the cellular level. To understand why fatigue is plaguing you in the first place, we must examine how your cells make energy.

Your mitochondria are organelles that exist inside all of your cells and make energy. I like to think of the mitochondria as little engines. Your mitochondria work around the clock to convert sugars, amino acids, and fatty acids into a substance called adenosine triphosphate or ATP. ATP is the energy molecule of your body. Your cells use it for many biochemical jobs — from muscle contraction to hormone production. So your mitochondria are responsible for your energy levels. You need a constant supply of ATP to live. In fact, without it you would die in seconds.

Like the engine of your car uses a process called combustion to convert oxygen and fuel into energy, your mitochondria use a process called the Kreps Cycle to convert oxygen and nutrients into ATP. The Krebs Cycle is a complex dance of chemicals within the mitochondria in your cells. Anything that impedes that process can make you feel fatigued.

When patients come to our office frustrated by chronic fatigue, this is where we look first. We look for things known to impact the Krebs Cycle and cause impaired mitochondrial function. Some of those things include exposure to toxins or mold; diseases such as Lyme disease, Epstein-Barr or other herpes viruses, thyroid hormone abnormalities, gastrointestinal disorders, intestinal permeability (‘leaky gut’), multiple chronic conditions, and nutrient deficiencies.

Fatigue is the main complaint of people who suffer from impaired mitochondrial function and decreased energy production. But there are other symptoms. You might also experience muscle aches or weakness, or an intolerance to exercise. Digestive issues, impaired immune systems, or migraines can also be traced back to mitochondrial function.

The good news is that there is a simple urine test, called the organic acid test (OAT), that detects abnormalities in the Krebs Cycle. The Organic Acid Profile is like an emission test performed on your car. The exhaust is examined to see how efficiently the engine is burning fuel. Similarly, certain compounds called “organic acids” in your urine reveal the efficiency of your body’s machinery. The Organic Acid Test can also help give clues to what might cause your mitochondria to not be functioning optimally including signs of yeast or bacterial infections. Armed with this information we can develop a protocol to boost your energy right now while you address the underlying condition that caused your body to decrease energy production.

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