Probiotic Strain Lactobacillus Reuteri (L. Reuteri) Improves Intestinal Health and Fights Bad Bacteria

Lactobacillus reuteri is a probiotic whose benefits have only recently come to light. Originally classified as a strain of Lactobacillus fermentum, it wasn’t until 1980 that L. reuteri was identified as a distinct species of lactic acid bacteria subsequent to research conducted in the 1960s by Gerhard Reuter, for whom L. reuteri was named.

In an article titled “The Lactobacillus and Bifidobacterium microflora of the human intestine: composition and succession,” it was observed by Dr. Reuter that L. reuteri and L. gasseri were the predominant indigenous Lactobacillus species in infants as well as in adults and that the microflora of these bacteria remains stable lifelong.1

L. reuteri Helps Reduce Diarrhea of Varying Causes

Healthy bacteria colonize the gut to help lower the risk of infection, and L. reuteri is no exception. In 40 children aged 6 to 36 months who were hospitalized with acute diarrhea caused mainly by rotavirus infection, daily administration of L. reuteri decreased the mean duration of watery diarrhea compared to a placebo.2 As soon as the second day of treatment, watery diarrhea was present in just 26% of those who received the probiotic compared with 81% of the placebo group. Stool sample cultures revealed L. reuteri as constituting more than three-fourths of total lactobacilli.

In another study involving children hospitalized with acute diarrhea, early treatment with a combination of L. reuteri and Lactobacillus rhamnosus given twice daily for 5 days was associated with a 48% reduction in length of hospitalization in comparison with a placebo.3 At the end of the study, rotavirus was detected in 46% of children who received a placebo and 12% of those treated with lactobacilli.

In a randomized trial involving 201 infants who were given L. reuteri, Bifidobacterium lactis, or no probiotics for 12 weeks, the control group had more episodes of fever and more frequent and longer diarrhea episodes than either treatment group.4 Compared to infants who received B. lactis or no probiotics, those who received L. reuteri experienced fewer clinic visits, child care absences, days with fever, and antibiotic prescriptions.

A meta-analysis of 8 trials that evaluated the effects of L. reuteri in diarrheal diseases in children concluded that the probiotic reduces the duration of diarrhea, increases the likelihood of cure, and, in preventive settings, lowers the risk of community-acquired diarrhea in healthy children.5

In adults, L. reuteri given twice daily for 4 weeks significantly lowered the incidence of antibiotic-associated diarrhea compared to a placebo.6 While half of the placebo group developed diarrhea during the treatment period plus 2 weeks of follow-up, just 7.7% of those who received L. reuteri developed the condition.

Probiotic Bacteria L. reuteri May Improve Constipation

And in adults with chronic constipation, a randomized, double-blind trial that evaluated the effects of 4 weeks of L. reuteri supplementation resulted in an average of 2.6 more bowel movements per week among those who received the probiotic compared to 1 additional bowel movement in the placebo group.7 Another investigation of L. reuteri in constipated adults revealed a decrease in the production of methane, which can slow intestinal transit, explaining the increased bowel movement frequency seen in previous studies.8

Beneficial Effects of L. reuteri on Harmful Microorganisms

Helicobacter pylori is a bacterium largely responsible for stomach ulcers and gastric cancer. In a randomized, double-blind trial involving 100 patients who were positive for H. pylori infection, L. reuteri administered alone inhibited H. pylori growth and, when administered with H. pylori eradication therapy, lowered antibiotic-associated side effects.9

When tested against Streptococcus mutans, one of the main dental caries–causing bacteria, yogurt that contained L. reuteri significantly inhibited growth, while yogurt that contained other lactobacilli failed to have an effect.10 In a double-blind trial, the yogurt made with L. reuteri significantly reduced oral Streptococcus mutans compared to a placebo. In a randomized, double-blind trial involving subjects with chronic periodontitis, Lactobacillus reuteri Prodentis orally administered for one month was associated with a significant reduction in plaque index, bleeding on probing, and probing pocket depths, while the placebo group failed to show a statistically significant improvement.11

Frequent urinary tract infection is a challenge faced by many women worldwide. A review of the effectiveness of probiotics for this condition found L. reuteri to be among two lactobacilli that had the greatest protective effect.12

Lactobacillus reuteri could have a place in promoting workplace wellness. A double-blind trial of 262 healthy workers who received a daily dose of L. reuteri or a placebo for 80 days resulted in a significant protective effect against respiratory or gastrointestinal illnesses requiring work absences among probiotic-treated participants.13 While 26.4% of the placebo group reported taking sick leave during the study, sick leave was taken by just 10.6% of the L. reuteri group. Among 53 shift workers, 33% in the placebo group reported being sick during the study compared to none among those who received L. reuteri.

Effects on Cholesterol and Beyond

A randomized trial that compared the L. reuteri strain NCIMB 30242 to a placebo among 127 subjects with high cholesterol levels resulted in a 9.14% decrease in total cholesterol, an 11.64% reduction in low-density-lipoprotein cholesterol, and an 11.3% reduction in non-HDL cholesterol in probiotic-treated participants compared to the placebo group.14 High-sensitivity C-reactive protein (a marker of inflammation) and fibrinogen were also decreased among those who received the probiotic compared to the placebo. Interestingly, in another randomized trial, supplementation with L. reuteri NCIMB 30242 was associated with an increase in serum 25-hydroxyvitamin D levels after 9 weeks compared to a placebo.15

New findings concerning L. reuteri indicate that the lactobacillus upregulates the hormone oxytocin, associated with mood and human bonding.16

“It is now understood that gut bacteria exert effects beyond the local boundaries of the gastrointestinal tract to include distant tissues and overall health,” write S. E. Erdman and T. Poutahidis in the International Review of Neurobiology. The authors mention that Lactobacillus reuteri upregulates the hormone oxytocin and systemic immune responses, providing many health benefits. Some of these include wound healing, mental health, metabolism, and muscular and skeletal health.

Future research will reveal more concerning the mechanisms and effects of the living organisms that constitute L. reuteri, whose beneficial coexistence with humans has truly earned them the oft-heard moniker of “friendly bacteria.”


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Is Metformin the Aspirin of the 21st Century?

During the latter half of the 20th century, a cheap, readily available drug used by millions of people as a fast-acting and reliable pain reliever began to be revealed as something more. 1-5

Little by little, studies uncovered associations between aspirin use and a lower risk of cardiovascular events (including ischemic stroke and heart attack), preeclampsia, cognitive decline, an array of cancers, and even premature mortality from all causes in a number of patient populations.

Meanwhile, a drug introduced in 1957 in France became available for the first time in the U.S., in 1995, for the treatment of type 2 diabetes. An analog of biguanide drugs that have their origin in French lilac (Galega officinalis), metformin increases insulin sensitivity and lowers the liver’s production of glucose, making it a popular and effective antidiabetic drug that was incorporated into the World Health Organization’s list of essential medicines.

Metformin, an ancient herbal remedy derived from the French lilac, appears in herbal guides dating back to the 17th century. French scientist Jean Sterne published about the properties of metformin, and he named the compound Glucophage, which means glucose eater.6

Modern Day Usage of Metformin

Metformin is widely used and that its potential clinical applications continue to expand. For example, metformin is currently being studied as a treatment to promote longevity, and this suggests that its future applications are broad.6

“Metformin is everywhere,” observed Roberto Romero and colleagues in a 2017 review. While originally introduced into clinical practice as an antidiabetic agent, the roles of metformin as a therapeutic agent are expanding; they include prediabetes, gestational diabetes, and polycystic ovarian disease. Also, several experimental studies and observations from randomized clinical trials indicated that metformin could be useful for preventing or treating preeclampsia.7

Calorie restriction is a well-studied approach that has resulted in an extension of life span in nearly every species tested. Calorie restriction down-regulates the secretion of insulin and insulin-like growth factor 1 activity. Metformin, by activating AMP-activated kinase (AMPK), may elicit similar effects, making it a calorie restriction mimetic.8 Interestingly, AMPK is also activated by salicylate, aspirin’s major breakdown product.9 Both compounds have been associated with protection against cancer.

In the worm C. elegans, metformin extended median life span and prolonged the ability to move around in a youthful way.10 In mice bred to develop mammary tumors, metformin decelerated the age-related increase in blood glucose and prolonged the mean life span by 8% and the maximum life span by a month in comparison with control mice.11 A comparison of the effects of metformin and aspirin on the longevity of crickets resulted in a maximum life span of 194 days in association with aspirin, 188 days with metformin, and 136 days for unsupplemented controls. While aspirin was associated with a greater life extension benefit, metformin was associated with a greater delay in maturation age and reduced growth rate in both sexes.12

Review of Literature: Health Effects of Metformin

In a review article that analyzed 53 studies, J. M. Campbell and colleagues reported that diabetics taking metformin, compared to nondiabetics, had a 7% lower risk of all-cause mortality over followup. Diabetics who used metformin had a 28% lower mortality risk than diabetics who used non-metformin therapies. Metformin users also had a reduced risk of cancer compared to nondiabetics and less cardiovascular disease in comparison with diabetics who received treatments other than metformin. “The apparent reductions in all-cause mortality and diseases of aging associated with metformin use suggest that metformin could be extending life and healthspans by acting as a geroprotective agent,” the authors concluded.13

In a study that included a large group of male, type-2-diabetic veterans aged 65 years and older who were free of age-related comorbidities between 2002 and 2003, the use of metformin reduced the risk of cardiovascular diseases (CVD), cancer, depression, dementia, and frailty-related diseases, together as well as individually.14 Another study of older, type-2-diabetic veterans found an 8% lower risk of death during an average period of 5.6 years among frail subjects treated with metformin compared to those treated with sulfonylurea drugs.15 However, when those without frailty were examined, the use of metformin was associated with a 31% lower risk of death, suggesting that metformin could promote longevity by preventing frailty in older diabetics.

Looking Forward: Benefits of Metformin

What’s in the future for metformin? The Targeting Aging with Metformin (TAME) randomized trial, which plans to enroll 3,000 subjects between the ages of 65 and 79 years at 14 U.S. centers, will assess the time to a new occurrence of a composite outcome that includes cardiovascular events, cancer, dementia, and mortality over followup, as well as other end points, in metformin users and nonusers.16

“If successful, TAME will mark a paradigm shift, moving from treating each medical condition to targeting aging per se,” remarked Nir Barzilai and colleagues in an essay. “We expect this to facilitate the development of even better pharmacologic approaches that will ultimately reduce healthcare costs related to aging,” the authors wrote.16

Like aspirin, metformin may be a wonder drug, aiding in the prevention or treatment of a number of serious diseases and helping protect against premature mortality. While aspirin is easily purchased over-the-counter, metformin requires a prescription. As with any drug, there are possible side effects and conditions under which metformin should not be used. Ask your physician if metformin is right for you.


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Chasteberry: Women's Best Friend (and Men, too!)

Vitex agnus-castus, also known as the chaste tree, is a shrub whose berries, leaves, and seeds are used primarily for reproductive system conditions. Among women, Vitex agnus-castus is commonly utilized for premenstrual syndrome (PMS) symptoms, including painful breasts, menstrual disorders, fibrocystic breast disease, infertility, preventing miscarriage, and increasing breast milk production.

Men use the herb to help alleviate the symptoms of benign prostatic hyperplasia and to improve libido. It has non-reproductive system uses as well.

Vitex agnus-castus is a source of the flavone apigenin — and the apigenin flavone glucoside vitexin — which has antioxidant, anticancer, anti-inflammatory, antihyperalgesic, and neuroprotective effects.1-3 Another compound, casticin, has a significant ability to inhibit lipid peroxidation.4

In female rats with normal and induced aging, an extract of Vitex agnus-castus helped normalize aging-related effects that included follicle-stimulating-hormone (FSH) and luteinizing-hormone (LH) elevations as well as decreased estrogen and antioxidant enzyme levels.5

Chasteberry and Prolactin

Research in rat pituitary cells revealed an inhibitory effect for Vitex agnus-castus extract against excess secretion of prolactin — a hormone that enables milk production in women — suggesting its use as an alternative therapy for individuals with hyperprolactinemia (elevated blood levels of prolactin).6 High prolactin levels are associated with infertility, low libido, and bone loss in women and erectile dysfunction in men. In a randomized, double-blind, placebo-controlled trial involving women with a condition known as latent hyperprolactinemia, the administration of a 20-milligram capsule of chaste tree fruit for three months was associated with a reduction in prolactin release, normalization of shortened menstrual cycle luteal phase (which occurs following ovulation), and improvement in luteal phase progesterone synthesis.7 Women who received chasteberry also experienced an increase in beta-estradiol during this phase.

Investigation of the prolactin-suppressive mechanisms of Vitex agnus-castus has revealed compounds with an ability to bind to receptors for the neurotransmitter dopamine, which aids in the control of the brain’s pleasure and reward centers, among other functions.8 Pharmacologic research has confirmedthe dopaminergic effect of extracts of chasteberry and suggests actions via opioid receptors.9,10

Chasteberry and PMS

A trial that investigated the effects of daily chasteberry extract supplementation, during three menstrual cycles among 43 women with premenstrual syndrome, resulted in a significant reduction in symptoms that gradually returned after the supplement was discontinued.11 Another trial that compared the effects of chasteberry extract to a placebo, among 170 women with PMS, determined that improvement in irritability, mood alteration, anger, headache, breast fullness, and other premenstrual symptoms was greater among those who received the extract — and that the treatment was well tolerated.12 In a trial involving Japanese women with PMS, daily administration of Vitex agnus-castus extract for three cycles revealed decreases in irritability, depressed mood, anger, headache, bloating, breast fullness, skin disorder, fatigue, drowsiness, and sleeplessness.13 The rate of response to the extract increased over time, with 91% of the participants showing a response at the third menstrual cycle. A double-blind, placebo-controlled trial that included 217 Chinese women with PMS also resulted in improvement in association with treatment with Vitex agnus-castus extract for up to three cycles.14

Yet another trial, which evaluated the effects Vitex agnus-castus administered for six days prior to the menses for six cycles among 128 women who suffered from PMS, resulted in significant improvement among those who received the herb in comparison with a placebo.15 The authors noted two important differences between their study and others: increased duration of treatment (six months instead of three) and cyclic use instead of daily usage (six days instead of 30 days).

A randomized, controlled trial that compared the effects of chasteberry to pyridoxine (vitamin B6), among women with premenstrual tension syndrome, found that chasteberry was associated with greater alleviation of typical complaints: breast tenderness, edema, inner tension, headache, constipation, and depression.16 In a trial that compared the effects of Vitex agnus-castus to fluoxetine (Prozac) in women with premenstrual dysphoric disorder (PMDD, a more severe form of premenstrual syndrome), a similar number of participants responded to both treatments; however, fluoxetine was more effective for psychological symptoms and chasteberry for physical symptoms.17

A systematic review of eight randomized trials that involved women with PMS or PMDD found positive effects for Vitex agnus-castus in all trials, as well as safety.18 Another review, which included 43 studies reported between 2009 and 2016, concluded that Vitex agnus-castus helped treat premenstrual syndrome, alleviated postmenstrual pain, and was beneficial for women experiencing infertility.19

Among women with cyclical mastalgia (breast pain), Vitex agnus-castus extract given daily for three menstrual cycles was associated with a greater reduction of pain intensity in comparison with a placebo.20 A review published in Evidence-Based Complementary and Alternative Medicine concluded that, “Data from randomized and non-randomized well-conducted studies provides convincing evidence to suggest that A. castus is safe, effective, and well tolerated in a majority of patients suffering from mastalgia.”21

Women who suffer from migraine headaches often experience worsening of the condition in the premenstrual phase. A study that included 100 women with migraines and PMS who were given Vitex agnus-castus daily for three months resulted in two-thirds of the participants reporting a dramatic reduction in PMS symptoms; 42% of the subjects experienced a reduction in frequency of monthly migraine attacks that was greater than 50%.22 Fifty-seven percent of the women had a reduction of over 50% in the number of monthly days with headache.

PCOS, Menopause, and Beyond

A review of preclinical and clinical studies that investigated the effects of alternative therapies for polycystic ovary syndrome (PCOS) and related decreased or absent menstruation, as well as elevated male hormone levels, revealed evidence for equivalent effects for Vitex agnus-castus and the drug bromocriptine.23

Difficulty in the ability to remember or concentrate is a common complaint among postmenopausal women. In a study involving female rats that had their ovaries removed to mimic human menopause, Vitex agnus-castus extract, as well as the hormone estradiol, improved learning and memory in comparison with a control group.24

“Fruits of Vitex agnus-castus have been used in the treatment of many female conditions”, wrote A. Rani and A. Sharma in a recent review. These conditions include: menstrual disorders such as amenorrhea and dysmenorrhea, premenstrual dysphoric disorder (PMDD), insufficiency of the corpus luteum, hyperprolactinemia, disrupted lactation, infertility, acne, menopause, cyclic breast pain, and cyclical mastalgia. Diarrhea, flatulence, and inflammatory conditions are also included.

Vitex agnus-castus seems to hold great potential for an in-depth investigation for various biological activities,” the authors wrote.25


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What Every Woman Needs to Know About Hormone Replacement

Lorraine Maita, MD

Hormone Replacement Therapy: Safe Solutions for Healthy Aging

Many women fear the onset of menopause. They find the changes in their minds and bodies to be
depressing. Most women gain weight and lose bone, hair, and memory, and their risk for cardiovascular disease increases. They suffer from hot flashes, night sweats, sleep disruption, mood swings, irritability, dry and sagging skin, loss of interest in life, low libido, anxiety, and depression.

The landmark 2002 study Women’s Health Initiative (WHI) initially scared many doctors from prescribing hormone replacement therapy, and women feared taking it. After years of researching the subgroups in this study and analyzing new trials of bioidentical hormone replacement therapy, there is new evidence that hormone replacement therapy can be beneficial.

Menopause Could Speed Up Aging

A research study found that cellular aging increases by an average of 6% in menopause. This seemingly small amount can add up over a lifetime.1,2Sleep disruption can age women faster. Postmenopausal women with five insomnia symptoms were, in another study, almost two years older biologically than women the same chronological age with no insomnia symptoms."3,4

Doubts About Conclusions from the Women’s Health Initiative

The Women’s Health Initiative (WHI) emphasized the risks of hormone replacement therapy. One of the principal investigators in the study describes how the findings were misinterpreted. He discusses that there was no statistically significant harm for either breast cancer or heart attacks for women who began replacement therapy before age 60; therefore, women who abandoned hormone replacement therapy suffered needlessly. They were denied the benefits of relief from hot flashes, night sweats, sleepless nights, dry vagina, and painful intercourse, as well as the decreased risk of bone loss and cardiovascular disease.5 Even long-term use may be safe since other studies did not show an increased overall mortality in an 18-year follow-up of postmenopausal women who received conjugated equine estrogens with medroxyprogesterone acetate for an average of 5.6 years, or conjugated equine estrogens for an average of 7.2 years.6

Problems with the WHI Study

Part of the challenge with the WHI study has been that it only showed increased risk in cases in which estrogens were combined with progestins but the use of unopposed estrogen was not linked to an increased risk of breast cancer. As compared with the WHI hormone formulations, the use of bioidentical estrogen and progesterone was associated with much better protection against breast cancer. The equine estrogens and synthetic progestins used in the WHI study are different in their chemical structures from the natural hormones that are produced in a woman’s body.7 Many studies have revealed that synthetic progestins and bioidentical progesterone have very different effects on tissues; while synthetic progestins may increase estrogen-stimulated breast cell proliferation, progesterone inhibits this activity.8

Also, while progesterone has anti-estrogenic activity in breast tissue, synthetic progestins bind estrogen receptors in breast tissue and show estrogenic properties.8 Finally, synthetic progestins convert weaker estrogens into more potent estrogens, while progesterone has the opposite effect.8 Moreover, transdermal (through the skin) estradiol, a route that avoids the ”first-pass” effect, was as effective as oral formulations, but it was associated with a better safety profile.9 The adverse effects of the synthetic progestin medroxyprogesterone acetate, including its increased risk for breast cancer, stroke, and cognitive dysfunction, have been documented in several studies.10

Further Evidence of the Benefits of Bioidentical Hormone Replacement Therapy

A 2009 Postgraduate Medicine review analyzed whether or not bioidentical hormones are safer or more efficacious than commonly used synthetic versions. Based on physiological data and clinical outcomes, the study concluded that bioidentical hormones are associated with lower risks of breast cancer and cardiovascular disease, and are more efficacious than their synthetic or animal-derived counterparts.8 Many other subsequent studies support these findings.8,11,12,13,14,15,16

The Route of Administration of Hormone Therapy Affects the Risk

Studies in Climacteric found that giving estrogen transdermally decreases the risk of clots, embolisms, strokes, and gallbladder disease. Bioidentical progesterone had positive effects on decreasing blood pressure, clots, and embolisms and even breast cancer – contrary to the synthetic form medroxyprogesterone acetate (MPA). 11 The authors concluded that transdermal estrogen and oral progesterone are better hormone replacement options.12

Estrogen Has Many Health Benefits

The health benefits of hormone replacement therapy are many. Studies showed the benefits of estrogen on memory and executive function.17,18,19 While the greatest benefits occur at a younger age, even women over 65 had improvements.20,21 Bioidentical hormone replacement was also more effective than placebo in preventing depression.13 Coronary artery calcium scores were lower in the group taking hormones and hormone therapy, and mortality rates and the incidence of cardiovascular diseases were reduced.22 One proposed mechanism by which estrogen decreases the risk of cardiovascular disease may be by controlling the outflow of sympathetic and parasympathetic activity.23

Reanalysis of data from clinical trials using age stratification found decreased coronary disease and all-cause mortality in women aged 50-59, without the risk of breast cancer. More risks of some complications, such as osteoporotic fractures, were seen in women who abruptly stopped HRT.14 HRT also significantly decreases the incidence of various symptoms of menopause and the risk of osteoporotic fractures −and it improves quality of life. In younger healthy women (aged 50-60 years), several meta-analyses now consistently show reductions in coronary heart disease (CHD). In addition, the reanalysis of data from the WHI, and additional studies conducted since then, confirm that there is a decrease in cardiovascular diseases and mortality when HRT is initiated soon after menopause.15 The International Menopause Society published its governing principles based on a review of the literature from 2013 onward. In general, they supported individualized treatment, as it is effective for vasomotor symptoms, urogenital atrophy, and improved quality of life.24


It is time to take the fear out of using hormone replacement therapy and to take a look beyond the myths propagated by the flawed conclusions in the Women’s Health Initiative. Subsequent studies have shown a multitude of benefits and less risk when hormones are given to the appropriate population.

About: Lorraine Maita, MD

Lorraine is a recognized and award-winning holistic, functional, and anti-aging physician and author. She transforms people’s lives by getting to the root cause of illness using the best of science and nature. Her approach is personalized— you are treated as the unique individual you are. Her areas of expertise include: bioidentical hormone therapy, weight loss, treating chronic illness, and executive health. Dr. Maita served as Chief Medical Officer and Medical Director for three Fortune 100 companies and is an Advisory Team Member for WOR radio, the #1 news/talk radio station in the New York metropolitan area. She has a private practice in New Jersey, and her website is She is the author of Vibrance for Life: How to Live Younger and Healthier.


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Recognizing and Correcting Mitochondrial Dysfunction with Thiamine (B1)

Chandler Marrs, MS, MA, Ph.D.

Mitochondrial damage and dysfunction sit at the nexus of a range of disease processes across the lifespan. Evidence suggests that everything from the metabolic disturbances observed with obesity, cardiovascular disease, and diabetes through the neurodegeneration observed in many of the aged, like Alzheimer’s and dementia, involve distressed mitochondria. The origins of mitochondrial distress are multiple. Genetics plays a role, but so too do a myriad of environmental factors, from poor diet to chemical exposures. Mitochondria, it appears, are uniquely susceptible to epigenetic and environmentally induced damage. Many types of physiological stressors, lifestyle variables, and environmental and pharmaceutical exposures, can trigger symptoms in formerly asymptomatic carriers of mitochondrial DNA (mtDNA) mutations and/or evoke entirely new disease processes in which the primary disease had not been recognized previously.

The Impact of Mitochondrial Dysfunction

Though they were once believed to be rare, we now know that mitochondrial damage and dysfunction are common. By some estimates, as many as 1 in 200 of us carry mutations in the mtDNA. Whether any of those mutations induces illness, however, seems to come down to a number of factors, not just genetics. Nutrition is key among those variables. Nutrients form the backbone of the mitochondrial machinery, determining not just how much cellular energy (ATP) can be derived from diet — perhaps the most critical function of mitochondria — but also how effectively the mitochondria can respond to and clear toxins and manage all of the processes central to these organelles. Among the processes mitochondria control are cell excitability (Ca2+ homeostasis), cell death, steroidogenesis, inflammation and immune function, and reactive oxygen species–caused cellular damage. Quite simply, healthy mitochondria are requisite for a healthy cellular function.

Fatigue: A Hallmark of Mitochondrial Distress

The cardinal symptom of distressed mitochondria is fatigue. Considering the mitochondria’s role in energy production, it makes sense that the physiological response would be reduced energy capacity. As benign as fatigue sounds, however, at the molecular level, fatigue represents something far more damaging, particularly when chronic and unremitting. It suggests that the mitochondria are struggling to maintain basic functions. As one might expect, organ systems that require the most energy, like the central nervous system and the cardiovascular system, take the largest hits, but inasmuch as mitochondria provide energy for every cell, tissue, and organ, no system is left unchallenged.

Recognizing Mitochondrial Distress

The autonomic nervous system is particularly hard hit when the mitochondria are struggling. This results in a sort of autonomic chaos clinically deemed dysautonomia. To the extent that the autonomic system controls all automatic survival functions like heart rate and rhythm, digestion, temperature regulation, electrolyte regulation, sleep-wake cycles, gait and balance, and even mood regulation, disturbances can be quite perplexing. More often than not, the sheer diversity and inconsistency of symptoms lead many physicians to attribute the conditions to psychogenetic origins. They are not. In fact, if someone presents with unremitting fatigue, along with a host of seemingly disparate symptoms, ones that defy diagnostic categories, I would argue that mitochondrial dysfunction ought to be considered. And once one arrives at the mitochondria, diet and nutrients become key drivers.

Mitochondrial Nutrients: What about Thiamine?

One of the more interesting aspects of mitochondrial therapeutics is that successful treatment protocols involve nutrition: supplying the mitochondria with nutrients that facilitate the conversion of food to cellular energy or ATP. In order to get from macronutrients — ingested carbohydrates, proteins, and fats — to ATP, the mitochondria require no less than 22 separate micronutrients: nutrients that are not always available with the modern western diet, may be blocked by medications, and/or are unabsorbable due to faulty genetic machinery.

A growing body of research shows just how important these nutrients are to the mitochondria and to your health. The most researched nutrients include many of the B vitamins, Coenzyme Q10, and magnesium. Among these, thiamine (thiamin, vitamin B1) may be the most important. Thiamine sits atop the pyruvate pathway and is critical for the multiple enzymes involved in the conversion of dietary carbohydrates into ATP. It is also involved in fatty acid oxidation (alpha oxidation in the peroxisomes), linking thiamine to myelination and other critical lipid dependent processes. Diminished thiamine, thus, results not only in diminished cellular fuel and fatigue, but also a myriad of other reactions that ultimately result in ill health.

Thiamine insufficiency and frank deficiency has become increasingly common in western countries where high-calorie, low-nutrient diets and chronic medication use pervade. Dietary insufficiency effectively starves the mitochondria of critical nutrients, while medications further tax the already distressed organelles and increase the need for additional nutrients. The endless feed-forward loop of deleterious compensatory reactions forms the backbone of modern disease: increased inflammation, altered immune response, and disturbed metabolism. That these disease processes emanate from distressed mitochondria suggests that if we were to heal or at least support the mitochondria, many of these symptoms would dissipate. Research bears this out. Dietary and lifestyle changes, along with the therapeutic use of nutrient supplements, particularly thiamine, can unwind a wide variety of complex — and, often seemingly intractable — health issues. It would seem prudent, then, that health ought to begin with the mitochondria.

About: Chandler Marrs, MS, MA, Ph.D., is an accomplished researcher and writer with hundreds of articles on a diverse range of topics to her credit. Her company, Lucine Health Sciences, conducts direct-to-patient research on adverse reactions to medications and publishes an online health journal called Hormones Matter. Most recently, Dr. Marrs, along with renowned thiamine expert, Derrick Lonsdale, co-authored the seminal textbook on thiamine deficiency: Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition.

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