ABSTRACT
Introduction ...................................................................................................................................... 74 Mitochondrial Disease Basics .......................................................................................................... 74
Primary Mitochondrial Disorders Are Common ......................................................................... 74 Secondary Mitochondrial Damage Is Widespread ...................................................................... 74 Psychiatric Comorbidities ........................................................................................................... 75 Let Food Be Medicine ................................................................................................................. 75 Mitochondria Need Nutrients ...................................................................................................... 75 Mitochondrial Energetics and Cellular Homeostasis .................................................................. 76 Disrupt Mitochondria Induce Disease .........................................................................................77
Environmental Factors Affecting Mitochondrial Health ..................................................................77 Nutrient Deciencies in the Land of Plenty ................................................................................77 Conventional Agriculture and Food Nutrient Availability ..........................................................77 Pharmaceutical and Environmental Exposures Deplete Mitochondrial Nutrients ...................... 78 Mitochondrial Risk Not a Prerequisite for FDA Approval ......................................................... 79 Environmental Pollutants ............................................................................................................ 79 Chronic Illness and Poor Nutrition ............................................................................................. 79
Mitochondria and Brain Function ....................................................................................................80 Mitochondria and the Brain ........................................................................................................80 Compensatory Reactions of Cerebral Mitochondrial Dysfunction .............................................80 Orexin/Hypocretin Neurons ........................................................................................................80 Lactate as a Marker for Mitochondrial Functioning ................................................................... 81 Vitamins and Brain Inammation ............................................................................................... 82
Mitochondrial Mental Health: A Case for Thiamine ....................................................................... 83 Thiamine’s Role in Brain Health.................................................................................................84 Long Latency Thiamine Deciency ............................................................................................84
Clinical Presentation and Therapeutic Options ................................................................................85 Clinical Presentation of Adult Mitochondrial Dysfunction ........................................................85 Fatigue and Depression ...............................................................................................................85 Autonomic Dysregulation ...........................................................................................................86 Cerebellar Dysregulation and Ataxia ..........................................................................................86 Psychiatric and Cognitive Disturbances ......................................................................................86 Myopathy and Myalgias ..............................................................................................................87 Gastrointestinal Dysmotility .......................................................................................................87 Skin and Hair...............................................................................................................................87 Mitochondrial Support ................................................................................................................87
Conclusion .......................................................................................................................................88 References ........................................................................................................................................ 89
Mitochondria provide 90% of the adenosine triphosphate (ATP) required to maintain cellular function and viability via the interconnected processes of the Krebs/tricarboxylic acid cycle (TCA) and the electron transport chain (ETC).1 Impediments to ATP production imperil cell function and viability, eventually leading to cell death. Organ systems requiring the most ATP are especially susceptible to slight permutations in mitochondrial efciencies (e.g., the brain, heart, muscles, and gastrointestinal system). Nutrient insufciency is a key contributor to mitochondrial structural and functional derangement, capable of initiating and maintaining a variety of disease processes from diabetes and cardiovascular disease to the neurodegeneration observed in Alzheimer’s and Parkinson’s.2 Nutrient insufciency has become increasingly prevalent where Western dietary practices predominate and may underlie many of the diseases plaguing modern cultures. A growing body of evidence suggests that there is a connection between nutrient availability, mitochondrial health, and human health.
