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.


Anonymous said...

I was floxed by Cipro last October and am wondering if this is what is happening to me. I noticed when I started taking Liquid Magnesium Chloride that my "side effects" got a little better. Now I wonder if I need to add thiamine to my diet?

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