Fatigue may rank as one of the most frustrating symptoms for both patients and providers. Many surveys have shown that Americans don’t get enough sleep and are at risk for fatigue. One survey found 43 percent of Americans do not get enough sleep to mitigate critical risks that can jeopardize safety at work and on the roads, including the ability to think clearly, make informed decisions and be productive.

   One of the key recommendations for patients with fatigue has been exercise, yet that may worsen symptoms for some. One underlying cause of fatigue is mitochondrial dysfunction and we now know fatigue is a frequent symptom in mitochondrial dysfunction.

   Heavy mitochondrial function is akin to the amount of pressure the foot puts on the gas pedal. Low levels of the cellular energy currency adenosine triphosphate (ATP) lead to having weak metabolism and feeling slow.

   Mitochondria are basically the powerhouse of your cells that serve as batteries to power a variety of functions in your body. They are located in differing concentrations in various tissues throughout the body and are designed to serve the purpose of these specific tissues.

   The two main functions of the mitochondria include cellular respiration and energy production. Your mitochondria require both oxygen from air and glucose and fat from food in order to generate energy in the form of ATP. The mitochondria play a role in other functions, including cellular energy production, calcium homeostasis, promotes cell growth and multiplication, is responsible for cell death, generates oxidative radicals, supports nervous system function, heat production and organs of metabolism.

   Metabolic diseases including Type 2 diabetes, insulin resistance and prediabetes are common causes of fatigue in patients. There has been plenty of research showing a connection between insulin secretion/glycemic control and mitochondrial health. When mitochondria become dysfunctional, they can affect the pancreatic beta cells which have been implicated in the pathology of chronic  metabolic disease.

   The following are some causes of mitochondria fatigue.

   Genetic Issues: In most people, the main cause of mitochondrial health problems and primary mitochondrial disease is an inherited genetic condition.

   Chronic Inflammation: This condition is a problem for mitochondrial function and overall health because it causes the body to break down. It’s largely caused by free radicals which target and damage healthy cells. Antioxidants are the natural predators of free radicals.

   Toxin Exposure: Environmental toxins are an increasingly recognized cause of a variety of health issues, including inflammation, autoimmune conditions and cancer. Exposure to environmental toxins can contribute to chronic oxidative stress and increase your risk of mitochondrial health problems.

   Chronic Infections: Infections are invasions by pathogens, such as viruses, bacteria, fungi and parasites that lead to damage in the body. The most common chronic viral infections include the Epstein-Barr virus, hepatitis and herpes. The most common bacterial infections include bladder and urinary tract infections.

   Poor Lifestyle Habits: You need to eat plenty of antioxidants. If your diet is filled with inflammatory foods and empty calories from refined sugar or processed foods and/or low in antioxidant-rich greens, vegetables and fruits, then too many free radicals are produced which in turn results in inflammation, cellular and tissue damage and mitochondrial problems. Poor sleeping habits, a lack of exercise and chronic stress can increase your risk of inflammation, oxidative damages and mitochondrial problems.

   You can improve your mitochondrial health and reduce the risk of mitochondrial problems and symptoms by following some of the dietary and lifestyle strategies.

   Nutrient-Rich Nutrition Plan: Switching to this can improve your mitochondrial function, lower inflammation, decrease oxidative damage and reduce your risk of health problems. Eliminate inflammatory foods such as refined sugar and carbs, bad fats, gluten, casein and artificial ingredients. Eat plenty of greens, vegetables, herbs and fruits that are rich in antioxidants, vitamins and minerals. Fill up on healthy fats such as avocados, coconut oil, coconut butter, grass-fed butter and ghee, MCT oils and organic pasture-raised eggs. Consume clean proteins such as grass-fed beef, wild-caught salmon, pasture-raised poultry and wild game. Organ meats are also beneficial.

   Ketogenic Diet: This is high in fat and low in carbs. Research has shown that this diet can slow the progression of a mitochondrial disease and positively influence longevity pathways. Ketogenic diets may reduce inflammation, increase mental clarity, focus and concentration, provide you with more energy, slow aging and reduce the risk of chronic diseases.

   Regular Exercise: The average American spends 20 to 21 hours in a lying or sitting position. Regular exercise can improve mitochondrial health, maintain your muscle tone, improve your sleep, boost your immune system, better your cognitive abilities and increase your lifespan.

   Intermittent and Extended Fasting: When you are fasting, damaged mitochondria become purged through a process called autophagy or mitophagy. Fasting has many health benefits.

   Supplements & Lifestyle-Based Interventions: Mitochondrial integrity is essential to maintain an adequate immune system response against SARS-CoV-2 infection. Here are some supplements and lifestyle-based interventions: Antioxidant supplementation, plant-based diets, CoQ10 supplementation, N-acetylcysteine supplementation, Acetyl-L-carnitine, a-Lipoic acid, curcumin, nicotinamide riboside and resveratrol.

   Sleep: With the brain requiring a lot of energy, it accumulates a lot of metabolic waste. During sleep, the brain gets rid of products that can be toxic to mitochondria.

   Relaxation Techniques: Stress can alter mitochondrial structure and function through stress hormones and other stress signals that are sensed by mitochondria. Meditation, yoga, tai chi or breathing exercises can help manage stress.

   Sunlight: The right amount of sun is fundamental for our health. Vitamin D is necessary for mitochondrial activity.

   Red/Near-Infrared Light Therapy: This can penetrate the skin and act on mitochondria through stimulation of a molecule called Cytochrome C oxidase. This therapy enhances the efficiency of the mitochondrial electron transport chain and energy production.

  Cold Exposure: Cold exposure in the form of cold showers or cryotherapy can boost mitochondria to keep us warm.

   Heat Exposure: Heat stress triggers beneficial adaptive responses in mitochondria that increase their functional capacity.

   Supporting NAD+: NAD+ is a molecule derived from vitamin B3 found in every single cell in the body, NAD+ is essential for the maintenance of health.