(02) 9299 0134
L4/65 York St, Sydney, 2000


Historically, as a symptom fatigue has not been well managed in Australia. In fact fatigue is the most common unexplained complaint that people present with to their GP. In Functional Medicine fatigue and energy production are one of our main focuses as part of the first body system.

We have already discussed the role of the HPA axis in maintaining health and optimal energy levels. Another important component of energy production is the health of your mitochondria.


The mitochondria are the power plants of human cells. The Citric acid cycle, also known as the Krebs cycle results in the production of chemical energy in the form of adenosine triphosphate (ATP). It is this chemical energy that is literally the energy currency of life. The Krebs cycle produces ATP within the matrix of your mitochondria. When your ATP production is off then you can expect to go through life with the hand brake on.

There are many disorders that can result from Mitochondrial dysfunction:

  • Lack of energy (physical or mental)
  • Diminished endurance
  • Weakness
  • Depression
  • Fibromyalgia
  • Chronic fatigue
  • Autism
  • Cancer
  • Diabetes
  • Truncal hypotonia (floppy baby)
  • Cardiomyopathy (heart disease)
  • Schizophrenia
  • Bipolar disease


When there is a nutrient deficiency due to diet, inborn genetic errors of metabolism, faulty digestion or faulty detoxification pathways then the citric acid cycle, ATP production and ultimately energy levels are negatively impacted. 

Sources of fuel for the citric acid to produce energy (ATP) can be divided into three types. 

  1. Fats – This is the most efficient source of fuel to produce energy. Carnitine is required to transport fatty acids into the citric acid to produce ATP. When there is a deficiency of carnitine, resulting in problems with fatty acid metabolism then people start to put on weight and become extremely weak and fatigued with exertion.
  1. Carbohydrates–Glucose and other sugars are utilized by the citric acid cycle to produce ATP. Vitamins B1, B2, B3, B5 and Lipoic acid are required at sufficient levels to produce energy from dietary carbohydrates. When there is a disruption in carbohydrate metabolism this will result in elevated blood sugar which can lead to insulin resistance and ultimately diabetes. It was also result in fatigue due to a decrease in ATP
  1. Proteins–Amino acids from protein are the least favoured source of fuel to produce ATP. Your body will only use this as a fuel source as a last resort. In times of great stress due to deficiencies in fatty acid and carbohydrate metabolism amino acids from muscle or the lining of the gut can be broken down and used as a source of fuel. This is an extremely damaging and inefficient way to produce energy.

The beauty of Functional Medicine is that we can test how well you are producing energy through the Organics Acid Test. Because ATP production is so crucial to all life functions, the recent ability to assess mitochondrial function has been central to Functional Medicine programs. Macro and micro nutrient replacement with certain vitamins and nutrients like coenzyme Q10 and carnitine means it is possible to restore energy levels even in people with genetic polymorphisms.


The main way mitochondria become damaged is through Oxidative stress. Energy is produced in the mitochondria predominately via oxidative phosphorylation thanks to the actions of the ever important coenzyme Q10. As mitochondria produce ATP they simultaneously yield Reactive Oxygen Species (ROS) which are harmful free radicals. These free radicals will circulate throughout the body damaging mitochondria. Degenerative diseases such as Parkinson’s disease, Alzheimer’s, Multiple Sclerosis, heart disease, cancer and strokes have been linked to oxidative stress.

Environmental toxins, chemicals, prescription and recreational drugs, renal and liver disorders can also cause mitochondrial damage through oxidative stress. The third body system consists of the detoxification pathways. Your body burden, the accumulated level of toxins will have a large impact on the amount of damage from oxidative stress that your mitochondria will experience.


Increasing intake of Antioxidants via food and supplements is helpful in protecting mitochondria;

  • Vitamins A, B2, B3, C and E
  • Bioflavonoids such as resveratrol, curcumin and quercetin
  • Glutathione
  • Beta-carotene
  • Selenium
  • Coenzyme Q10 or ubiquinol
  • Taurine
  • Support liver function

Reducing Pro-oxidants will help to repair and protect your mitochondria and slow the aging process;

  • Toxic pesticides
  • Ionizing radiation
  • Cigarette smoke
  • Stress
  • Heavy exercise
  • Excess alcohol


Due to the fact that ATP is at the centre of all life processes, the factors affecting mitochondrial ATP synthesis have huge consequences for human health.

Mitochondrial disease is generally diagnosed at birth due to often severe consequences. Genetic mutations in mitochondrial DNA cause mitochondrial disease.

Nutritional problems, heavy metals, toxins and intestinal dysbiosis can cause problems with energy production within the citric acid cycle. This is what we are testing for when an organic acids is recommended. By restoring correct function of the citric acid cycle, energy levels improve, insulin sensitivity improves, weight loss becomes easier and often mood will greatly improve.

Have a Question?

Get in Touch