The Key to More Energy: Nourish Your Mitochondria

By David N. Ilfeld, M.D.
Board Certified in Internal Medicine, Rheumatology, Allergy & Immunology, & NSI Scientific Advisory Board Member

August 02, 2007 - Not having enough energy is a common complaint that occurs for a number of reasons including lack of sleep, poor diet and poor mood. Products containing caffeine or stimulants may give you a short-term boost, but addressing energy at a cellular level may be a better long-term solution. Your cells contain structures called mitochondria, which are tiny "power houses" that produce the energy which fuels your entire body. Mitochondrial performance may be improved with help from certain nutrients.

You may often feel tired and fatigued. This fatigue may be due to emotional problems (such as excessive worries or poor mood), sleep disorders and/or physical problems. Particularly, as people get older they tend to suffer more from fatigue. Is there something we can do to help with fatigue?

One frequently overlooked cause of fatigue is a low or borderline-low level of vitamin B12. The best response for this is a high dosage of vitamin B12, either orally or sublingually (a small tablet under the tongue which is absorbed in the veins under the tongue). Ideally, methylcobalamin, which is the neuro-active form of vitamin B12, should be used. Taking folic acid together with vitamin B12 may be even more effective.

Poor mood is very common and is often undiagnosed and untreated. Physicians and therapists can usually help people with chronic poor mood. But many people with fatigue do not have major emotional problems, sleep disorders or a specific physical illness.

A frequent cause of non-specific fatigue, especially as we get older, is the decreased ability of cells to produce energy. Approximately 95% of energy production occurs in "power houses" called mitochondria, located inside each cell. Mitochondria have their own membranes and their own RNA and DNA (genetic material). Mitochondria produce adenosine triphosphate (ATP) which is the main chemical for storing energy; however, this process also causes the production of free radicals which damage mitochondrial function.

Is there something to try to improve mitochondrial energy production? Yes! Acetyl L-carnitine is a nutrient that helps transport long-chain fatty acids (fats) into mitochondria and increases mitochondrial energy production. Acetyl L-carnitine should not be taken alone because it increases oxidative stress from free radicals1.

Alpha lipoic acid is a powerful "universal" antioxidant which acts in fat-soluble and water-soluble areas of our bodies. Antioxidants interact with free radicals and become inactive. Alpha lipoic acid can recycle inactive antioxidants (such as vitamin C, vitamin E, coenzyme Q10 or other molecules of alpha lipoic acid) back into active antioxidants. Alpha lipoic acid also assists with the metabolism of glucose (sugar).

Researchers at the University of California, Berkeley have done exciting research showing that feeding old rats a combination of acetyl L-carnitine and alpha lipoic acid can improve mitochondrial function while protecting from oxidative stress from free radicals1. Old rats fed with acetyl L-carnitine and alpha lipoic acid had more motor activity1. They also had one-third the motor activity compared to young rats1. Furthermore, old rats given acetyl L-carnitine and alpha lipoic acid had improved memory2. In these experiments, the combination of acetyl L-carnitine together with alpha lipoic acid was better than giving either acetyl L-carnitine or alpha lipoic acid. Acetyl L-carnitine should always be taken together with alpha lipoic acid.

Coenzyme Q10 (CoQ10) is needed by mitochondria for electron transfer in order to produce chemical energy (ATP). CoQ10 is another powerful antioxidant which can also protect mitochondria from free radical damage. Levels of CoQ10 in the body drop dramatically with age. The combination of CoQ10 with acetyl L-carnitine and alpha lipoic acid may be best for improving mitochondrial energy production while protecting from free radical damage.

Nutraceutical Sciences Institute® (NSI®) has a new product called Mitochondrial Energy Booster which supplies a high dose of neuro-active vitamin B12 (methylcobalamin) with folic acid; vitamin E, B-complex and magnesium (which are important for energy production); and benfotiamine (which can protect from free radicals forming advanced glycation end-products which can damage cells).
Most importantly, Mitochondrial Energy Booster contains 200 mg of CoQ10, 300 mg of alpha lipoic acid and 1,000 mg of acetyl L-carnitine. These are effective dosages which may help you to improve and protect mitochondrial energy production and may increase mental and physical energy. CoQ10 is fat-soluble; so for optimal absorption, Mitochondrial Energy Booster should be taken as two capsules twice daily with meals which include fat—preferably a healthy fat such as extra-virgin olive oil.

CoQ10 is important for cardiovascular health. It's also important for promoting neurological health. Acetyl L-carnitine also promotes cardiovascular and neurological health. Furthermore, alpha lipoic acid may help promote neurological health. These subjects have been covered extensively by Dr. Allen S. Josephs in his For Your Health newsletters. The combination of CoQ10 together with acetyl L-carnitine and alpha lipoic acid may be even more effective for promoting cardiovascular health as well as neurological health.

Mitochondrial Energy Booster also has an effective dosage 800 IU of vitamin D-3 (cholecalciferol) which is important for healthy bones, protection from abnormal cell growth, immune health as well as cardiovascular and neurological health (see the recent series of Dr. Josephs' Newsletters on vitamin D-3 and the New England Journal of Medicine review article3).

In my clinical practice, I've seen people with non-specific fatigue increase energy levels by taking effective dosages of CoQ10, alpha lipoic acid and acetyl L-carnitine together with B-complex, magnesium and other nutrients. If you have fatigue, look at the possible causes, consider getting professional care and consider taking NSI® Mitochondrial Energy Booster.

1. Hagen TM, Liu J, Lykkesfeldt J, Wehr CM, Ingersoll RT, Vinarsky V, Bartholomew JC, Ames BN. Feeding acetyl-L-carnitine and lipoic acid to old rats significantly improves metabolic function while decreasing oxidative stress. Proc Natl Acad Sci USA. 2002 Feb 19;99(4):1870-5.
2. Liu J, Head E, Gharib AM, Yuan W, Ingersoll RT, Hagen TM, Cotman CW, Ames BN. Memory loss in old rats is associated with brain mitochondrial decay and RNA/DNA oxidation: partial reversal by feeding acetyl-L-carnitine and/or R-alpha -lipoic acid. Proc Natl Acad Sci U S A. 2002 Feb 19;99(4):2356-61.
3. Holick MF. Vitamin D deficiency. N Engl J Med. 2007 Jul 19;357(3):266-81.

http://www.vitacost.com/newsletter/...YH20070802:main

Have you taken this product? Can you tell us your experience of it?

BTW I'm not directing this at you - this is just something that has been brewing in me for a while - and I need to get it out :-) okay?

I am not one to just go off and start taking a bunch of individual supplements. I think that everyone should start out taking a high quality "mega" multi-vitamin and lots of fish - wait a couple of months - and then go from there.

That said - yes a lot of people, especially those with type 2 diabetes or on their way to type 2 diabetes - are deficient in B12 - and many other nutrients. Does B12 help them - you bet. But I think that "taking a high quality "mega" multi-vitamin and lots of fish" would help a whole lot more.

Current thinking in medicine is - one problem - one solution. My thinking is more like - let's try to eliminate all the nutritional problems first - and then start there as a base line. There is a theory - about balancing the body - that western medicine does not believe in. But I feel that my body is a whole more balanced today than it was before Atkins diet - and I feel like a different person.

People spend way too much time trying to exactly nail a medical problem - is this colitis, is this diverticulitus, is this Chrone's, is this ____ (insert your favorite bowel disease name here). Now some people are saying - I have Chrone's with a touch of colitis.

I'm making up some of this - but my point is - IMHO- if all these people went on the Atkins diet - eliminated all grains, starches, and anything not very low glycemic - and took "a high quality "mega" multi-vitamin and lots of fish" - I'll bet that at least 50% - probably closer to 80% of all these problems would go away - in a couple of months!

Back to your question - are you going to see a huge difference?

If you are taking "a high quality "mega" multi-vitamin and lots of fish" - probably not.

If your health is screwed up and not taking ""a high quality "mega" multi-vitamin and lots of fish" then it would probably help - but still not much unless one is low carbing also.

Proper nutrition is what you eat and what supplements you take. IMHO one without the other - helps - but both are synergistic - more than twice as good as one or the other.

B vitamins are what are put into all the energy drinks - so yes - I think there is some basis for it.

high quality CoQ10, in amounts over 100 mg, is suppose to be good, but expensive.

Alpha Lipoic Acid is very good
Acetly L-Carnitine is very good

will try to post more info on these later

The reason I left the specific name of that product in there - is so that people can go see what ingredients are in that product - and think about each ingredient and how much they are already getting

BTW - I do take a high quality multi- 4 grams of fish oil - plus other seperate supplements including CoQ10, ALA, and Acetyl l-carntinine.

I agree with you and I'm as frustrated as you are. When I attempt to explain that to people though, they look at me dismissively as if I haven't yet heard that fat and cholesterol are bad for you, as if I'm just pitifully ignorant. I'm sure it doesn't help that I'm obese -- we're already perceived as stupid anyway.

It has to come from the medical community. Why aren't doctors up to date on all the low carb research that I find online?

BTW, thanks for all the supplement information you post here. I've been getting back on track for the past month (social obligations took me way off course this spring and summer) and I've been tackling the supplement issue this week. I've found tons of great help in this subforum, much of it from you.

CoQ10

http://lpi.oregonstate.edu/infocenter/othernuts/coq10/

http://www.worldhealth.net/p/aadr-coenzyme-q-.html

http://www.vitacost.com/articleResu...&ss=1&Ntt=coq10

http://search.lef.org/search/defaul...s=1&QUERY=coq10

B12

http://lpi.oregonstate.edu/infocent...ins/vitaminB12/

http://www.worldhealth.net/p/aadr-v...ocobalamin.html

http://www.vitacost.com/articleResu...es&ss=1&Ntt=b12

http://search.lef.org/search/default.aspx?s=1&QUERY=b12

Alpha Lipoic Acid

http://lpi.oregonstate.edu/infocent...ndex.html#intro

http://www.worldhealth.net/p/aadr-a...ipoic-acid.html

http://www.vitacost.com/articleResu...20lipoic%20acid

http://search.lef.org/search/defaul...20lipoic%20acid

Acetyl L-Carnitine

http://lpi.oregonstate.edu/infocent...nuts/carnitine/

http://www.worldhealth.net/p/aadr-a...-carnitine.html

http://www.vitacost.com/articleResu...l%20L-Carnitine

http://search.lef.org/search/defaul...l%20L-Carnitine

To finally getting around to answering your question

I do take a high quality "mega" multivitmain (8 capsules per day) plus four grams of high content fish oil.

Then I take an additional 400 mg of chromium, mixture of magnesium, condrotin mix for joints, turmeric (curcumin) for inflammation, 200mg of a special form of Coq10, acetyl L-Cartinine (1 g = 1000 mg), and 600 mg of Alpha Lipoic Acid, plus a boatload of salt substitute (potassium).

My multivitamin gives me
Vitamin B12 (methylcobalamin) 1.00 mg (1,000.00 mcg) 16,666%

which also has all the other B vitamins plus many other vitamins and minerals

I take the coq10, ALC and ALA because they are suppose to be universal antioxidants.

One of the major hurdles of losing weight - and Dr Atkins briefly glossed over this - and probably should have expounded on it more - is that as you burn fat - all that fat has all kinds of crap trapped in it - that it just lets loose in your blood stream. So waste removal becomes very important.

I don't know that Coq10, ALC, and ALA are the best for doing that - but I figure it has to help.

Is it mandatory - no. Is it better than not taking it - probably.

I feel that it does help my body some - but I could never quantify that.

It's a question of how much $ you want to spend. The way I justify the $ is that if I did not do all of this - the doctor, hospital, and prescription drug costs, time away from work - would be huge $.

no one believed in this diet when I started. One of the most disappointing things about the miraculous health recovery I have made - is that - I thought that by leading by example - people that knew me would question conventional medical wisdom and give it try. Nope. Nada. Although the people that I know don't harass me anymore (like saying "that diet will kill you") - they still do the same stupid stuff.

They sit there with all those health problems, they see their friends and family dropping dead around them - they see the changes I have made - and it never clicks!

What can you do?



I hate conspiracys - but this has to be one. If 50 to 80 % of all medical problems, doctor visits, prescription drugs, hospital visits, etc went away in a couple of months - what would happen to the medical industry?

When the FDA and AMA can tell everyone in the medical industry what to think and do - or else they will be thrown in jail and have their credentials revoked ...



No problem - with the discussion that I talked about above - this forum gives me some release to think that I am at least helping someone.

It truely is a miracle what happened to me - and I want everyone else to witness the same miracle.

Because they're busy people with lives, too?

1. "online" is not generally accepted as evidence. There's as much hogwash "online" as there is good stuff.

2. Medicine moves slowly.

3. Most of the doctors I know are NOT fat and do not suffer from the same problems that bring us to this board and to this WOE. They simply don't have the same experience. The way we select and educate doctors has something to do with this.

4. Despite KE's thinking, LC isn't going to fix it all.

5. Who listens to doctors? Really--how many times did a doctor make lifestyle suggestions that we ignored or didn't want to hear? If people listened to doctors, why does ANYONE still smoke? Or drink too much?!?

Given that we heard suggestions about improving our lives a number of times, but the individual doctor was making them to ALL patients and therefore was experiencing "being ignored" thousands of times, most of them just give up. It's a wonder they keep at it at all, frankly. When I listen to an acquaintance go on about how she lies about her blood sugars and then gets caught out on the HgA1C #, I wonder why her endo doesn't just strangle her with a stethoscope. I would have to slap her, myself. And the MD probably has a practice FULL of people like that.

6. It just doesn't take a lot of IQ points to understand that cheetos are not health sustaining. It doesn't take an MD to explain that exercise helps everything. We can't afford to educate ourselves at $125/office visit, insured or not.

Well said, CS. I can imagine it's very frustrating to be a doctor, the time they can spend with patients is dwindling. However... on the other hand, there are a LOT of ill-informed doctors who got educated long ago and stopped learning anything the moment they got their sheepskin.

Still, with the Internet you've got a ton of resources around to educate yourself.

Now, having said all that, I've been interested in this mitochondrial energy thing for awhile and have been trying a protocol that one doctor is using on her CFS patients. It has helped a little, I seem to be getting more out of my thyroid meds than I was. Here's the thread that got me started on that: http://www.glutenfreeandbeyond.org/...topic.php?t=369

Now it certainly hasn't changed things a ton, I still feel kind of draggy all the time, even when I've had too much thyroid and I'm hyper, I'm still just a bit tired too. The one thing I want to add to my mixture of supplements is ALA.

I used to. My family does. Lots of people do. When I was growing up our pediatrician lived next door and we were always told, "fat is bad for you", "Americans eat too much protein", and "complex carbohydrates are good for you and give you energy". We ate according to these doctor-recommended guidelines: lots of bread, cereal, rice, potatoes, fruit, vegetables, nonfat milk and tiny portions of lean meat. Even as a small child I was only allowed nonfat milk. There was never any added fat, our family never had any packaged or prepared food or soft drinks or dessert.

I had such severe reactive hypoglycemia as a child in elementary school that my hands constantly shook, I felt weak all the time, and I occasionally blacked out. It was the doctor-recommended guidelines that did it to me. And the doctor-recommended treatment for hypoglycemia? Lots of fat-free complex-carbohydrates, eaten at two or three hour intervals. Which I followed religiously.

I am severely insulin-resistant now, thanks to the standard physician-recommended dietary guidelines. It was following all that bad advice that made me obese.


Ahem. That's going too far. I have never been a junk food eater and my IQ is well beyond average.

I agree. I have always preferred meat and eggs to anything else that I could eat. I was told that I need to try to cut out all meat, eggs, butter. I was told that eating low fat foods was the key.

But the more i ate that way - the worse my health got. Till finally I reread atkins which said to do the opposite - I thought why not try it - and sure enough - my health responded.