Mitochondrial Performance
The Hidden Cause of Fatigue, Brain Fog and Chronic Inflammation
By Dr. Alain Frabotta - Integrative Chiropractor, Naturopathic & Functional Medicine Clinician, Educator, Sydney, Australia, integrating nutritional, lifestyle, and genomic medicine into modern clinical care.
When the Body Whispers Before It Breaks
Fatigue, brain fog and chronic inflammation can feel like invisible chains, sapping vitality and clouding thought. Often these symptoms defy simple explanation: blood tests are “normal”, scans are unremarkable, yet patients feel something is deeply wrong.
In my Sydney practice as a chiropractor and naturopathic functional medicine clinician, I have come to recognise a common root hidden beneath these complaints – the silent failure of our cellular powerhouses: the mitochondria.
Mitochondria are tiny organelles in each cell that act like batteries, producing the energy currency ATP that powers everything from our heartbeat and breathing to the firing of neurons in our brain. [1]
When mitochondria work optimally, we have abundant energy, clear thinking and healthy tissues. But when they falter under chronic stress, toxins or nutrient deprivation, the whole body feels the strain.
Patients often describe it as “running on empty”: the workday drags on longer, concentration fades, muscles ache, and even the immune system seems sluggish.
The Mitochondria’s Core Purpose
Mitochondria are tiny structures called organelles found inside cells that convert food and oxygen into energy for the cell. [1]
They are complex living things found in most living organisms that play an essential role in driving the complexity of life on the planet. [1]
Mitochondria have their own DNA, as well as a small set of genes distinct from those found in the cell nucleus. It has been proposed that mitochondria evolved from symbiotic aerobic bacteria that were incorporated into the cell more than two billion years ago. [1]
Over 1,000 proteins and a large number of metabolic substrates are required for normal mitochondrial function, which is maintained through constant bidirectional communication with the nucleus. [2]
1. Energy Production (ATP Generation)
The mitochondria’s primary function is to meet the cell’s energy and metabolic demands through a process called oxidative phosphorylation. [2]
The mitochondria produce approximately 50kg of energy per day in a healthy person, of which the brain consumes approximately 6kg. [3] This could explain why the brain is frequently the first to show signs of mitochondrial dysfunction.
The mitochondria’s primary function is to convert food (carbohydrates, proteins, and fats) and oxygen into a usable form of energy known as adenosine triphosphate (ATP). [2] This fuels every physiologic process: brain function, heart rhythm, hormonal balance, immunity, detoxification, movement, and cellular repair.
2. Cellular Defence & Threat Detection (Cell Danger Response)
Mitochondria detect stress signals — infections, toxins, oxidative stress, nutrient depletion, trauma, chronic inflammation — and shift metabolism into protective mode. When this defence mode is prolonged, patients develop symptoms such as fatigue, pain, brain fog, low mood, and poor stress tolerance.
3. Regulation of Inflammation
Mitochondria orchestrate inflammatory signalling pathways, including NF-κB, NLRP3, ROS-mediated signalling, and mitochondrial DNA release. When mitochondrial function breaks down, inflammation becomes chronic, uncontrolled, and system-wide.
4. Hormonal & Metabolic Regulation
They influence thyroid function, insulin sensitivity, appetite regulation, cortisol rhythm, fertility, temperature regulation, and resting metabolic rate. Mitochondrial dysfunction often precedes clinical metabolic disease.
5. Immune, Cellular Repair, Growth & Longevity
Mitochondria manage apoptosis (programmed cell death), autophagy, redox balance, stem cell activation, telomere stability, and tissue regeneration — key determinants of ageing, disease progression, and recovery.
Mitochondria are also crucial for immune regulation, programmed cell death, calcium homeostasis, and stem cell regulation. When the immune system is activated to fight an infection or chronic illness, mitochondria shift from producing energy to supporting immune function. [4]
In the process of producing ATP, the mitochondria generate carbon dioxide, water, and free radicals called reactive oxygen species (ROS), which are unstable molecules capable of causing damage to your body. [2]
When mitochondria are degraded, damaged, or function inefficiently, free radicals can accumulate in cells, leading to mitochondrial dysfunction. To prevent damage caused by reactive oxygen species (ROS), mitochondria require antioxidants. [4]
6. Brain Function & Neuroplasticity
The brain consumes nearly 20% of the body’s energy. Mitochondria support focus, memory consolidation, neurotransmitter balance, neural repair, synaptic plasticity, and emotional regulation. Fatigue, brain fog, anxiety, and depression frequently reflect mitochondrial stress.
7. Movement, Muscle Health & Pain Modulation
Muscles are dense with mitochondria. Their function determines strength, endurance, exercise tolerance, lactic acid clearance, post-exertional fatigue, and recovery from musculoskeletal pain — critical for chiropractic and functional medicine practice.
Mitochondrial Dysfunction?
The mitochondria are susceptible to nutrient deficiencies, environmental toxins, and oxidative stress. [5]
According to research, the primary source of oxidative stress is the leakage of oxygen and high-energy electrons from the mitochondria. [5]
As a result of oxidative stress or free radical damage, the mitochondrial DNA undergoes structural changes, which have been associated with mitochondrial dysfunction, chronic inflammation and disease. [6,7,8]
The following factors may cause mitochondrial dysfunction or damage: [2,5,9,10,11]
Mitochondrial DNA damage, mutations, deletions or impaired DNA replication
Genetic predisposition or susceptibility (especially ApoE4)
Environmental toxins and pollutants such as moulds, viral infections, toxic metals, and persistent organic pollutants (POPs)
Cigarette smoke, alcohol and many prescription medications, such as NSAIDs, statins, antibiotics, anti-anxiolytics, antidepressants, antipsychotics, chemotherapies, metformin, etc
Adverse childhood events and traumatic stress
Nutritional deficiencies
Poor sleep quality, diet, and sedentary lifestyle
Sugar and processed foods (fructose-rich diet)
Inflammation and hyperglycaemia
Aging
Signs & Symptoms of Mitochondrial Dysfunction
Chronic fatigue is directly related to mitochondrial dysfunction. It can be described as a complex sensation characterised by a loss of overall energy and an inability to perform simple tasks. [13]
Psychological disorders can often cause fatigue, which is closely linked to mitochondrial function and is associated with chronic disease. [13]
The latest research suggests that mitochondria play a key role in a range of neuromuscular and neurodegenerative conditions and complex diseases, including [1,2,4,7,8,12,13]
Dementia and Alzheimer’s Disease
Amyotrophic Lateral Sclerosis, Huntington’s and Parkinson’s Disease
Autoimmune conditions, such as Multiple Sclerosis, Systemic Lupus Erythematosus, and Type 1 Diabetes
Insulin Resistance and Metabolic Syndrome
Cardiovascular Diseases, Chronic Fatigue Syndrome, and Fibromyalgia
Migraine Headaches and Gastrointestinal Disorders
Neurobehavioral and psychiatric diseases, such as autism spectrum disorders, schizophrenia, and bipolar and mood disorders
Altered mitochondrial function is a hallmark of many cancers, including breast, prostate and colon cancers, and age-related pathologies, and has been shown to play a role in metastasis.
Chronic infections: Lyme and mould
Neurodegenerative diseases (Alzheimer’s, ASD, Parkinson’s)
Cancer
CVD
DM and metabolic syndrome
Kidney disease
Common pathways are chronic inflammation and oxidative stress
Depression
The Powerhouse Within: How Mitochondria Fuel Life
Every cell in our body (except red blood cells) contains hundreds or even thousands of mitochondria. [1] These remarkable organelles burn oxygen and nutrients (glucose, fatty acids) to generate adenosine triphosphate (ATP) – the molecule that literally powers cellular work. [1]
Think of mitochondria as the tiny engines under the hood of each cell. When your muscles contract, your brain thinks, or your nerves fire, it’s ATP – made in mitochondria – that provides the energy.
Mitochondria contain their own DNA and evolved from ancient bacteria that entered our cells eons ago. They are perfectly adapted to their role: taking in oxygen and nutrients, they generate an electrical “charge” across their membranes, which is used by a series of molecular machines (the electron transport chain) to produce ATP. [1]
In effect, mitochondria are like highly efficient batteries that our cells constantly “recharge” by breathing and eating. The brain alone consumes about 20% of our total oxygen and relies heavily on well-tuned mitochondria.
Beyond energy production, mitochondria also sense and respond to cellular signals. [2] They have receptors for stress hormones such as cortisol (glucocorticoids), estrogen, insulin and more. [2]
In other words, mitochondria can detect changes in our internal environment – stress signals, nutrient levels or toxins – and adjust their function accordingly. During times of metabolic stress (high blood sugar, high fats, or chronic inflammation), mitochondria change shape (fission and fusion) and efficiency in order to adapt. [2]
When everything is balanced, mitochondria keep our cells humming. But when mitochondria are overloaded – by constant high demand, toxic insults, or insufficient cofactors – trouble begins.
ATP generation declines, cells switch to less efficient anaerobic metabolism (leading to lactic acid buildup), and reactive oxygen species (free radicals) accumulate.
This sets off a vicious cycle: damaged mitochondria produce more oxidative stress, which in turn damages more mitochondria and cellular components. Over time, this can trigger immune activation and chronic inflammation.
In sum, dysfunctional mitochondria starve cells (and tissues) of energy while simultaneously amplifying inflammation and fatigue throughout the body. [1][3]
From an integrative perspective, this is the point where Chiropractic, Naturopathic and Functional Medicine begin to ask a different question: not “What diagnosis do we label this?” but “What is draining the cell’s ability to make and manage energy?”
Symptoms of Mitochondrial Dysfunction: A Slow Drain on Vitality
When mitochondrial energy is compromised, symptoms gradually creep in. Patients may initially notice they are slightly more tired than usual, or that “moments of brain fog” occur, but chalk it up to stress or age. Over months or years, however, the energy drain can become profound.
Common manifestations of mitochondrial stress include:
Persistent fatigue – a profound exhaustion that isn’t fully relieved by rest or sleep. Routine tasks feel Herculean. Patients often say they need multiple coffees or naps to keep going, only to crash later.
Brain fog and cognitive sluggishness – difficulty concentrating, forgetfulness, slowed thinking or a “fuzzy” mind. This happens because neurons are starved of ATP, and synaptic function slows.
Muscle weakness or aches – with insufficient energy, even simple movements feel heavy. Muscles may fatigue easily during exercise or activity.
Chronic pain – ongoing low-level pain (backaches, fibromyalgia-like pain) can reflect mitochondrial strain. Poor energy metabolism in muscle and nerve cells makes pain signals more prominent.
Mood changes – low energy often comes with low mood, anxiety or irritability. The brain’s neurotransmitter balance depends on mitochondria, so when they flag, mental health can suffer.
Chronic inflammation – mitochondrial distress sends “danger” signals to the immune system. Immune cells respond by producing inflammatory cytokines. Over time, this can manifest as a low-grade inflammatory state – joint pain, allergies, gut issues or worsened autoimmunity.
These symptoms often co-occur, reinforcing one another: fatigue worsens mood, pain drains energy, and sleep may become poor (more on that shortly).
A key insight from functional medicine is that such chronic, multisystem complaints often reflect an underlying root cause – and mitochondrial dysfunction is one unifying culprit that ties fatigue, fog and inflammation together.
In fact, studies show that people with chronic fatigue symptoms frequently have measurable mitochondrial impairment in their cells. [4]
In one small study of older adults, those with fatigue had significantly lower mitochondrial respiration and ATP production in their blood cells than those without fatigue. [4]
In my experience, recognising and addressing mitochondrial health – while also correcting spinal, postural and biomechanical stressors – can transform a patient’s vitality.
Stress and the Energy Drain: How Constant “Fight or Flight” Harms Mitochondria
We live in a world of relentless stressors – busy schedules, emotional pressures, financial worries, even persistent low-level anxiety about news and social media.
Our bodies are designed to respond to acute stress, but chronic stress keeps the “alarm bells” ringing non-stop. Over time, this chronic stress response has a heavy cost on cellular energy.
Biologically, stress activates the sympathetic nervous system and the HPA axis, flooding the body with cortisol, adrenaline and other mediators. These stress hormones directly affect mitochondria.
Research shows that cortisol and related hormones can alter mitochondrial function and dynamics. In fact, mitochondria evolved to be sensitive to stress hormones – they carry receptors and machinery to “hear” these chemical signals. [2]
When cortisol is chronically elevated, mitochondria shift their balance toward fusion/fission, become less efficient, and begin to leak electrons, generating more free radicals.
Over time, repeated stress causes lasting changes in mitochondrial structure – what scientists now call “mitochondrial allostatic load” – essentially an accumulation of wear-and-tear on our cellular power stations. [3,5]
In practical terms, when stress is unrelenting, mitochondria adapt by dialling down energy production to conserve resources, at the expense of being energetically depleted.
The Picard & McEwen review of stress physiology describes how chronic psychological stress repeatedly alters mitochondrial structure and function, leading to the accumulation of mitochondrial DNA damage. [3,5] This is akin to a car repeatedly running with low oil – eventually the engine parts wear out.
Moreover, stress-driven insulin spikes (from sugar cravings or rushed meals) and high blood fats also perturb mitochondrial shape and efficiency. [2] All of this biochemical stress converges in mitochondria.
In the functional medicine world, we often say the nervous system is the “bridge” between mind-body stress and cellular energy. If someone is in a chronic sympathetic (“fight or flight”) state, their adrenal glands pump cortisol non-stop, telling mitochondria to ramp up fuel consumption even when it’s unnecessary. The result is rapid fuel burn, depletion of cofactors (such as B vitamins and minerals), and oxidative damage.
Clinically, many patients with adrenal fatigue or chronic anxiety share these mitochondrial changes. Low cortisol (adrenal burnout) paradoxically results in insufficient stress response, but still leaves mitochondria suffering from years of prior overdrive.
The key point is simple and reassuring: emotional and physical stressors directly tax mitochondria – and they are modifiable.
Managing stress – through lifestyle changes, relaxation techniques, chiropractic nervous system care, and mind–body practices – can significantly ease mitochondrial strain.
In our clinic, we incorporate breathing exercises, meditation, and gentle chiropractic adjustments to calm the nervous system, which in turn reduces cortisol surges and gives mitochondria a chance to recover.
Toxins and Pollutants: Environmental Overload on Cellular Engines
Our modern environment is full of toxic exposures that quietly erode mitochondrial function. Pollution particles in the air, pesticides on produce, heavy metals in water, and even everyday chemicals in plastics or household products can infiltrate our cells. Mitochondria, unfortunately, are especially vulnerable to these toxins. [6, 7]
Airborne particulates (smoke, smog) are inhaled and can travel to the brain and lungs, where they induce oxidative stress and inflammation. [6]
Studies have shown that particulates and ozone can disrupt mitochondrial membranes and reduce the number of functioning mitochondria in exposed cells.
In the IFM article “Toxic Environmental Exposures and Energy Production”, researchers note that exposure to particulate matter causes oxidative stress in the central nervous system and deterioration of brain health. [6]
Part of this damage is because mitochondria lack robust DNA repair mechanisms, so pollution-induced free radical assaults accumulate in them. [6]
Beyond air pollution, many heavy metals (such as lead, mercury, and arsenic) and chemical toxins (such as pesticides like DDT and herbicides like paraquat) are mitochondrial toxicants. [7] They disrupt the electron transport chain, increase reactive oxygen species, and even interfere with mitochondrial DNA replication.
For example, IFM cites that metals and pesticides are epidemiologically linked to neurodegenerative diseases precisely through their mitochondrial damage. [7] Even everyday plastics (phthalates, BPA) can leach into our bodies and stress mitochondria over time.
The cumulative effect is that our cells are carrying an invisible toxic burden. Often, the immune system gets triggered (hence chronic inflammation), but the deeper impact is an energy crisis at the cellular level.
In integrative practice, we often use nutritional and naturopathic detoxification strategies – binders like chlorella, fibre, targeted botanicals, cilantro for some metals, or sauna therapy – to gently support the body’s elimination of these toxins, thereby giving mitochondria a cleaner environment.
Reducing household toxins (using glass containers, filtered water, low-tox personal care products, organic foods where possible) also forms a key step.
The science is clear: environmental toxins induce mitochondrial dysfunction, and this fuel shortage manifests as chronic fatigue and inflammation. [6,7]
The hopeful message is that many of these exposures can be identified and reduced.
Nutrient Depletions: Starving the Cellular Engine
Mitochondria are chemical machines that depend on dozens of vitamins, minerals and cofactors to function. If key nutrients are missing, even healthy mitochondria sputter. In today’s refined-food diet and high-stress lifestyle, nutrient depletions are common, and they hit mitochondria hardest.
For example:
B vitamins – riboflavin (B2), niacin (B3), thiamine (B1) and others are essential coenzymes in the Krebs cycle and electron transport chain. Without them, ATP production grinds to a halt.
Coenzyme Q10 – a fat-soluble compound that shuttles electrons within mitochondria. Low CoQ10 (from statin drugs, ageing, or poor diet) causes an energy deficit.
L-carnitine – transports fatty acids into mitochondria to be burned for energy. Its deficiency (seen in some chronic illnesses) makes cells more reliant on glucose and less efficient.
Magnesium – a key cofactor for ATP synthesis, and also calms excess calcium in mitochondria. Low magnesium (common with stress and sweat loss) decreases ATP and raises oxidative stress.
Antioxidants (vitamin C, E, alpha-lipoic acid, glutathione) – these protect mitochondria from free radical damage. If they’re depleted, mitochondria sustain more wear-and-tear during normal metabolism.
The NIH Office of Dietary Supplements notes that clinicians treating mitochondrial disorders often prescribe supplements that are “nutrients and metabolic cofactors” to help increase ATP production or bypass cellular defects. [8]
In other words, providing mitochondria with the raw materials they need can sometimes overcome genetic or acquired deficits.
In practice, we test for common deficiencies and design diets rich in mitochondrial nutrients. For instance, a paleo-type or Mediterranean-style diet supplies many of these cofactors naturally: leafy greens (magnesium, B vitamins), oily fish (CoQ10, omega-3 fats), nuts and seeds (magnesium, vitamin E), and organ meats (B vitamins, carnitine).
Targeted supplementation also plays a role. Evidence from mitochondrial disease management shows benefits from CoQ10, riboflavin, creatine, carnitine and antioxidants. [9]
Even if a patient doesn’t have a rare genetic mitochondrial disorder, modest supplementation can “turbocharge” faltering energy systems.
For example, L-carnitine and CoQ10 are often used in chronic fatigue protocols because they help rebuild mitochondrial function.
In our naturopathic approach, we use high-quality multivitamins, B-complex, CoQ10, magnesium and glutathione precursors to replenish what modern life depletes. [9,8]
All this highlights a simple truth: you can’t get energy from energy; you must supply the parts of the energy machinery.
A functional exam might reveal pale nails (iron deficiency), poor reflexes (B12/B1 deficiency), or restless legs (magnesium deficiency), all of which can point to underlying cofactor deficiencies.
Addressing these not only boosts energy but also allows other therapies (such as sleep, stress management, and chiropractic care) to take effect more fully.
Infections and Immune Challenges: Hijacked Energy Factories
It is increasingly recognised that chronic infections can drive mitochondrial dysfunction as well. Viruses and other pathogens often hijack or stress our cells in ways that collide with mitochondrial operations.
A striking example is the Epstein–Barr virus (EBV), famous for causing mononucleosis and often implicated in long-term fatigue syndromes.
Research suggests EBV “reprograms” infected cells toward glycolysis (sugar-burning) rather than efficient mitochondrial respiration. [10] In essence, EBV infection forces cells to rely on quick-and-dirty energy pathways, generating by-products and inflammation instead of clean ATP.
A recent commentary on SARS-CoV-2 and EBV proposed that reactivation of EBV could deliver a “second mitochondrial whammy” in COVID-19 and long COVID patients. [10,11]
The idea is that EBV alters mitochondrial dynamics and DNA replication, reducing mitochondrial biogenesis (the creation of new mitochondria) and promoting apoptosis (cell death). [10]
This not only weakens the cell’s energy capacity but also releases inflammatory signals. It is no wonder that EBV reactivation can cause brain fog, profound fatigue and an “upsurge” of inflammation – these are classic signs of mitochondrial crisis. [11]
Other chronic infections play similar roles. Lyme disease bacteria, chronic mould exposure/mycotoxins, cytomegalovirus, and even persistent bacterial infections (like sinusitis or gut pathogens) can all create a state of constant immune activation. The immune response itself consumes energy, and the cytokines produced can directly influence mitochondria.
Our own immune cells rely on mitochondrial metabolism to fight pathogens; a heavy immune load can drain this system. Moreover, intracellular bacteria (like Coxiella or Chlamydia) can release toxins that perturb mitochondrial membranes.
Functional medicine labs often test for hidden infections in cases of unexplained fatigue for this reason. When I see high titres of EBV or evidence of tick-borne infections, I consider their impact on the patient’s energy.
Addressing these infections (with antivirals, herbal antimicrobials or immune support) often leads to gradual improvement in mitochondrial function.
In summary, chronic infections are energy thieves – they sap resources and provoke inflammation, forcing mitochondria to play defence rather than produce energy.
Disrupted Rhythms: The Cost of Poor Sleep and Skewed Clocks
Sleep is one of the simplest yet most powerful ways we restore mitochondrial health. Recent science vividly paints sleep as “mitorestorative” – a time when mitochondria fuse, rebuild and rebalance after the oxidative stress of wakefulness. [12]
An insightful review in Antioxidants describes how wakefulness drives a high metabolic rate and oxidative stress, whereas sleep promotes mitochondrial remodelling and replenishment of the cellular antioxidant balance. [12]
In other words, days are “nucleorestorative” (repairing DNA and making proteins), but nights are when mitochondria repair themselves. [12]
When our circadian rhythms are disrupted – by shift work, late-night screen time, irregular schedules or chronic insomnia – this nightly mitochondrial reset is short-changed.
Poor sleep leaves mitochondria stuck in an oxidative, high-stress mode for too long. Studies have shown that even one night of sleep loss can raise markers of mitochondrial stress.
Over the long term, not getting enough deep restorative sleep means damaged mitochondria can’t fully heal. [12] People with irregular schedules or sleep apnoea, for example, often feel persistently drained as if they “never get a full recharge.”
In practice, we prioritise sleep quality in regimens aimed at mitochondrial health. This means:
Regular sleep and wake times
Dark, quiet, cool bedrooms
Limiting blue light after sunset
Addressing sleep disorders such as apnoea or restless legs
When a patient finally sleeps soundly, they often describe waking up feeling “20% better” even if nothing else has changed. That aligns with the idea that mitochondria did much of their repair work overnight.
Beyond sleep, light exposure and circadian timing also affect metabolism.
Mitochondrial genes follow a circadian rhythm, and disruptions (such as jet lag or shift work) can throw off the internal clocks that regulate metabolism.
Emerging research links chronic circadian disruption to metabolic syndrome and inflammation, partly through mitochondrial pathways.
While much remains to be learned, a practical takeaway is that maintaining consistent daily rhythms – light in the morning, darkness at night, timed meals – helps synchronise mitochondria to a healthy cycle.
Integrative Strategies for Restoration: Reviving Your Cellular Powerhouses
The good news is that mitochondrial dysfunction is not irreversible. Because mitochondria are dynamic, they can recover, regenerate and even grow in number under the right conditions.
An integrative plan combines elements from Chiropractic, Naturopathic and Functional Medicine to “reboot” these organelles. The goal is to remove stressors, supply nutrients, calm the nervous system and optimise lifestyle so mitochondria can gradually restore their energy production.
1. Nourish with Mitochondria-Supportive Nutrition
A whole-food, anti-inflammatory diet is the bedrock. Focus on:
Colourful plant foods – leafy greens, berries, nuts and seeds provide antioxidants (polyphenols) that neutralise free radicals in mitochondria. [13]
Compounds in blueberries, green tea, and many herbs promote mitochondrial biogenesis (the formation of new mitochondria) and protect against damage.
High-quality proteins – meats, fish and eggs supply B vitamins (especially B12, riboflavin), carnitine and CoQ10, all crucial cofactors in ATP production. [8,9]
Wild-caught fatty fish is rich in omega-3 fats, which modulate inflammation and incorporate into mitochondrial membranes, making them more fluid and efficient.
Healthy fats – foods like avocados, nuts, olives and coconut provide fats that mitochondria can burn cleanly (via beta-oxidation). We also emphasise avoiding trans fats and highly processed seed oils, which can promote oxidative stress.
Regular meals with time-restricted feeding – emerging evidence suggests that giving our digestive system a nightly break (e.g. finishing eating by 7pm) can enhance mitochondrial function, similar to the benefits of intermittent fasting. [14]
This approach synchronises with our circadian rhythms: we fuel the body during daylight, then allow an overnight “fast”, which may stimulate mitophagy (the clearing of old mitochondria) and rejuvenation.
In addition, targeted supplements often play a role:
Coenzyme Q10 (CoQ10)
Acetyl-L-carnitine
Alpha-lipoic acid
NAD+ precursors (niacin, NR, NMN)
B-complex (especially B1, B2, B3)
Magnesium
Any supplementation should be individualised and introduced as part of a broader program. The NIH fact sheet on mitochondrial disorders emphasises that these nutrients can “increase ATP production” and help bypass some blocks in the energy pathway. [8]
2. Moderate, Regular Exercise
This may seem counterintuitive when you’re exhausted, but the right kind of movement is one of the best medicines for mitochondria. [15]
Exercise – especially gentle aerobic activity like walking, swimming or cycling – signals mitochondria to grow in number and efficiency (mitochondrial biogenesis).
One review notes that “physical activity is generally viewed as lifestyle medicine, as all mitochondria communicate with each other via myokines” and that exercise induces adaptations not just in muscle but system-wide. [15]
For patients with severe fatigue, we start with very low-intensity movement and gradually increase as tolerated. The aim is not to push through crashes, but to invite mitochondria back into service with sustainable, consistent signals.
3. Stress Reduction and Nervous System Care
Since chronic stress eats away at mitochondria, part of “rebooting” energy is deliberately cultivating relaxation and resilience.
Helpful strategies include:
Breathwork and meditation
Chiropractic adjustments and physical medicine to reduce structural stress and sympathetic overdrive
Mind–body practices like yoga, Tai Chi or qigong
Adaptogenic herbs such as Rhodiola rosea, Panax ginseng, and Withania somnifera (ashwagandha), which contain antioxidant and anti-inflammatory compounds that support the nervous system and, indirectly, protect mitochondria. [16]
By weaving stress-relief into daily life – whether through hobbies, nature, therapy or bodywork – we lower the allostatic load. Over time, calmer stress hormone levels mean mitochondria can shift from damage control back to energy production.
4. Sleep and Circadian Rhythm Optimisation
We’ve seen how crucial sleep is for mitochondrial health. [12] In practice, addressing sleep can be a game-changer.
We focus on:
Consistent bed and wake times
Dark, quiet, cool rooms
Reduction of screens and stimulants before bed
Assessment and management of sleep disorders
Exposure to natural daylight (especially morning sun) helps entrain the central clock, which in turn synchronises metabolic processes. In integrative practice, we may also use light therapy or melatonin (under guidance) to correct circadian disturbances.
5. Detoxification and Optimising the Internal Environment
We minimise ongoing toxin exposure and support the body’s natural detox pathways to lighten the mitochondrial load. This can include:
Gentle liver support (e.g. milk thistle, dandelion)
Adequate fibre and hydration
Infrared sauna or sweating, where appropriate
Magnesium baths to relax muscles and support cellular magnesium.
Functional labs can guide this: organic acid testing might reveal mould toxins or microbial by-products; toxin panels may identify elevated metals or industrial chemicals. The goal is not aggressive “cleansing”, but careful removal of burdens so mitochondria can refocus on energy.
6. Functional Medicine Testing and Personalisation
Finally, an integrative approach uses testing and whole-person assessment to tailor treatments. For mitochondrial issues, tests might include:
Nutrient panels
Hormone tests (adrenal, thyroid, sex hormones)
Metabolic profiling (organic acids, lactate)
Toxin panels
Selected genetic or microbiome tests
These help us craft a personalised healing plan and explain to patients why they feel the way they do – a key part of restoring hope.
A Journey Back to Vitality
Mitochondrial dysfunction is indeed “hidden” – standard medical tests rarely check it. But for many chronic fatigue and brain fog sufferers, it is the missing piece.
By seeing mitochondria as the central nexus where stress, nutrition, toxin load, infection, sleep and nervous system patterns converge, we can finally connect the dots in seemingly disconnected symptoms.
The path to healing is neither quick nor linear; decades of mitochondrial wear and tear cannot be reversed overnight.
But the body has a remarkable capacity to regenerate.
Patients who commit to an integrative program – nourishing food, restful sleep, stress management, targeted nutrients, gentle detox, appropriate movement, and structural nervous system care – often see slow but steady restoration of energy and clarity.
Over time, chronic inflammation eases as cellular metabolism normalises.
As a chiropractor and naturopathic functional medicine doctor, I find this work deeply rewarding.
It is inspiring to witness someone who once drifted through life with exhaustion gradually experience an inner brightening – clearer thoughts, stable moods, renewed zest for hobbies, time with family, or simply the quiet joy of not needing caffeine every hour.
The story of mitochondrial restoration is ultimately an empowering one: it reminds us that much of what our bodies need lies within our choices.
By caring for the body’s environment – its food, rest, structural balance, stress-load and toxin burden – we free the little engines inside each cell to do what they do best:
Keep us alive, energetic and well.
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