Your Guide to Mitochondrial Disorder and Treatment

By: Michael Lam, MD, MPH

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Subclinical Mitochondrial Disorder

Mitochondrial Disorder can affect Adrenal Fatigue and energy levelsCould a mitochondrial disorder be having an effect on your overall quality of life? One does not need to have a documented and diagnosable mitochondrial disorder to suffer symptoms of mitochondrial weakness. Be on the look out for fatigue, a low energy state, insomnia, water retention, low body temperature, reduced thyroid function, reduced gastric assimilation, a weak urine stream, menstrual irregularity, constipation, dry skin, and an unstable mood. Signs and symptoms of a mitochondrial disorder may be subtle, but they are clearly visible if you are on the alert. They point to a body that has reduced energy output from the mitochondria. These symptoms are similar to those experiencing hypothyroid or adrenal gland diseases such as Adrenal Fatigue Syndrome (AFS). Viewed objectively, it is clear that the body is unable to go into overdrive when called upon. There is not enough fuel. It is like a car that moves slowly despite the gasoline pedal in full open throttle.

As AFS progresses from mild to severe, peripheral organ resistance frequently develops. Thyroid replacement becomes less effective, and organ resistance to cortisol surfaces. In order to achieve the same therapeutic effect, hormonal dosages must be increased. Not everyone can tolerate higher doses, which has many undesirable side effects, including anxiety, heart palpitations, and insomnia.

With organ resistance, fewer hormones are able to reach the mitochondria to facilitate its function. Less energy will be produced as a result. A state of subclinical mitochondrial disease is, therefore, an inescapable reality for many. Practically speaking, almost everyone in advanced stages of AFS will have certain degrees of mitochondrial weakness and lowered energy output, even if there is an absence of clinical diagnosable mitochondrial disease.

Without fortifying the mitochondria as the adrenals are healing, overall recovery from AFS is often slow and retarded. That is why mitochondrial fortification should be part of every comprehensive adrenal fatigue recovery program. The key is to know when to support the mitochondria, as bad timing can make AFS worse, especially in advanced stages.

Strategies for those with Adrenal Fatigue Syndrome

If you have mitochondrial disorder and AFS concurrently with fatigue as the primary symptom, helping mitochondrial function should reduce fatigue in principal. This is true if AFS is in the early stages where fatigue is mild to moderate.

There are caveats, however. A significantly positive energy response with mitochondrial support may mask underlying unresolved adrenal problems. Energy levels can quickly reduce as mitochondrial support is withheld. It is important therefore that mitochondrial and adrenal support be concurrent but balanced. That way, when mitochondrial support is stopped, the adrenals are strong and well healed in order to continue unassisted and avoid any adrenal crashes. Failure to consider this two-pronged balanced approach is a common recovery mistake.

Most people have low energy levels with a mitochondrial disorderIf you are in advanced stages of AFS when fatigue is moderate to severe, or if you are house bound and have little energy to do but basic chores of normal living, embarking on mitochondria supplementation should begin only after the adrenals are stable, internal toxin levels reduced, the liver decongested, and the extracellular matrix cleansed. Dosage should start at a very low dose and titrate upwards to reach therapeutic goals.

Due to the prevalence of paradoxical reactions in advanced AFS, do not be surprised if the body rejects any of these good nutrients, even at low dosages. The more advanced the AFS, the higher the risk. It is not unusual for paradoxical reactions to surface, where fatigue is worsening. Exaggerated positive responses may also surface, resulting in a sense of anxiety, irritability, insomnia, and heart palpitations. Both are undesirable and indicate dosage and delivery system adjustments are needed. Both occur when the mitochondria are overstressed or receptor site sensitivity increased. It is a sign that the body is not quite ready for mitochondrial support.

Catabolic State and Mitochondrial Support

Those who are in a catabolic state where the body is losing muscle mass and protein and thus weight need to be extremely careful when it comes to mitochondrial support. Examples are those in very advanced stages of AFS, in post-surgery, with large open wounds. They are already in a fragile state within. Many have concurrent low body fluid volume, low blood pressure, temperature intolerance, electrolyte imbalance, delayed food sensitivity and intolerance, receptor sight disorders, liver congestion, extracellular matrix pollution, and severe fatigue.

The body is in a slow-down mode, with all nonessential functions, such as reproduction, shut off in order to conserve energy for survival. That is why most at this stage have low libido and irregular or absent menses. At the same time, the autonomic nervous system is activated and on full alert. As a result, the body is flooded in a sea of norepinephrine and adrenaline. The body is entrenched in a fight or flight mode at this time. The mitochondria are one of the last soldiers standing and working hard to put out the necessary ATP to keep the vital organs functioning, especially the heart, liver and kidneys. Already overworked mitochondrial cannot be stressed further. What the mitochondria needs is rest. It should not be driven to work harder by any nutrients even though they are supportive of mitochondrial function in normal situations.

Nutrients, no matter how good, administered at the wrong time will worsen the overall condition. Recognizing the proper timing is an art requiring extensive clinical experience correlating the state of the body with its ability to tolerate different kinds of nutrients. Failure to consider these factors is a common reason for AFS recovery failure.

Further ramping up mitochondrial function when the mitochondria is already at or close to peak output may lead to reduced marginal return over time at best. Energy output may go up for a short time and then plateau, while anxiety escalates quickly, leading to a state of wired anxiety. Those with AFS may experience adrenal crashes, with extreme fatigue and physical incapacitation. Many are bedridden for days and sometimes weeks.

Use natural compounds to help with a mitochondrial disorderTo avoid this, a better strategy is to reduce internal sympathetic tone and its hormones norepinephrine and adrenaline load first through stabilizing and healing the adrenals. This is best accomplished by a comprehensive recovery program using gentle and nurturing natural compounds. Herbs, glandular, and hormone should be avoided. The focus is on building and providing an alternative nutritional safety net for the body to dip into at times when it needs energy in order to stabilize and turn off the sympathetic alarm response. As the body regains its calm with this strategy, symptoms such as anxiety, fatigue, hypoglycemia, and insomnia reduces. Symptoms suggestive of sympathetic overtone commonly seen in advanced AFS such as heart pounding, postural hypotension, lightheadedness on arising, reactive hypoglycemia, and heart palpitations will resolve spontaneously. Once this is achieved, the next step is to make sure the extracellular matrix is cleansed and the liver is not congested. Only after these conditions are met should one proceed on mitochondrial support, which will yield results without the risk of decompensating adrenal crashes.


Mitochondrial disorder is a category of different diseases grouped together. The common characteristic is the same—fatigue and low energy state from reduced mitochondrial ATP formulation. Fortunately, there are natural compounds with proven mitochondrial support. The most important nutrients include co-enzyme Q10, magnesium, glutathione, vitamin D, and arginine. Because the cell wall protects the mitochondria, a proper delivery system is of vital importance to ensure bioavailability for this key to any successful mitochondrial disorder recovery program. Sufferers of Adrenal Fatigue Syndrome, especially in advanced stages, invariably have some level of mitochondrial weakness. Recovery faces special challenges with timing, dosage, and delivery system needed for mitochondrial support. Extensive clinical experience is required to avoid adrenal crashes and retarded recovery.

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© Copyright 2015 Michael Lam, M.D. All Rights Reserved.

Mitochondrial disorder