THE MIGHTY MITOCHONDRIA
Mitochondria are tiny sausage-shaped bits of tissue that float in the cell sap. There are a zillion of these tiny powerhouses in the body. As sources of cellular energy, mitochondria were recognized almost one hundred years ago. In the past, these cellular organelles were of interest only to the students of biology. The pandemic of the chronic fatigue syndrome, it seems to me, will change this. People who suffer from persistent and disabling fatigue are not interested in one more diagnostic label from their physicians. They want a deeper understanding of this problem. Some of my colleagues are waiting for wonder drugs that will cure this syndrome. My clinical experience with this problem leads me to think otherwise. It is only through a clear understanding that we can reverse chronic fatigue and restore health. I discuss this subject in detail in the companion volume The Canary and Chronic Fatigue.

Mitochondria are present in all eukaryotic cells (all living cells except bacteria, viruses and blue-green algae, none of which contains any nuclei), and play a central role in sustaining aerobic (oxygen-dependent) cellular energy functions.

MITOCHONDRIA: THE ENERGY CAPSULES

Mitochondria look and function like "tiny energy capsules." These energy capsules have an inner core substance (matrix) and two coverings (membranes). The outer membrane is smooth in surface, is about 50% lipids and carries specific enzymes including monoamine oxidase enzymes that oxidize and degrade stress hormones (adrenaline and related catecholamines and other molecules such as lactic acid). Anxiety and panic molecules, I might add, are predominantly the same. The inner membrane of mitochondria is about 20% lipid and 80% protein. It has folds called cristae and carries ATPase, which is the principal energy enzyme, and cytochrome enzymes, which are the principal enzymes involved in detoxification. The major cytochrome enzymes are designated as cytochrome P-450 enzymes and are named b, c, c1, a, a3 enzymes.

The matrix of mitochondria carries most of the respiratory enzymes of the citric acid cycle that are involved in the breakdown of sugars, proteins and fats for energy generation.

Cells that require the most energy contain the most energy generating mitochondria. The cells of the brain, the skeletal muscle and heart muscle, and the eye contain the highest number of mitochondria (as many as 10,000 per cell) while the skin cells, which do not require much energy, contain only a few hundred of them.

ATP: THE ENERGY MOLECULE

The principal energy molecule in the human body is adenosine triphosphate (ATP).

ATP molecules are produced in the cells by the oxidation of carbohydrates, proteins and fats. The enzyme systems involved in this process are collectively called cellular respiratory and oxidative phosphorylation systems. These enzyme systems are contained in the mitochondria. The energy carried by ATP molecules is used or stored depending on the needs of the body. These processes are regulated by several factors including the efficiency of enzymes, the extent of enzyme inactivation by intracellular enzyme poisons and the metabolic needs of the cells at the time.

NATURE AT ITS SUBLIME MAN AT HIS MOST RIDICULOUS

Nature is at its sublime when we reflect on mitochondria. Man is at his most ridiculous when I reflect on chronic fatigue syndrome.

Mitochondria control their own destiny. Nature, it seems, planned to preserve mitochondria even when the cell that houses them incurs serious damage. How did nature choose to create special protection for mitochondria? It gave them their own DNA that controls their structure, function and survival. It has been estimated that approximately one trillion cells and over a quadrillion mitochondria replicate every few weeks. It is easy to see the enormous potential for errors in formation of mitochondria. Indeed, mutations involving mitochondria indeed occur with high frequency. Normally, such mutations do not cause significant energy disorder and fatigue. Such is the state of perfection endowed to mitochondria by nature.

Enter man at his most ridiculous. We have brought upon ourselves chemical and electromagnetic avalanches. We have polluted our air. We have poisoned our water. We have contaminated our food with pesticides and fungicides. We stuff the guts of our babies with antibiotics before they have any chance of developing strong bowel ecology. I reiterate here what I wrote before: Human molecular defenses exist as plants rooted in the soil of the bowel contents. Antibiotics are designer killer molecules, and so are pesticides. These are powerful oxidant molecules. earth's atmosphere is basically an oxidant environment. With our synthetic chemicals, we have enormously increased the oxidant potential of earth's atmosphere.

Poor darlings, our mitochondria! They are no match for man's ingenuity and capacity for destruction.

INJURED MITOCHONDRIA CAUSE CHRONIC FATIGUE

I consider this the essence of the pervasive problem of chronic fatigue. The injured mitochondria mutate at much higher rates. Damaged mitochondria are exhausted mitochondria. Exhausted mitochondria cannot produce sufficient ATP molecules. An insufficient supply of ATP molecules means insufficient energy. Insufficient molecular energy means clinical chronic fatigue. Chronic fatigue syndrome is nothing but a diagnostic label that we physicians love to invent to hide our ignorance. This also explains my opinion that there will never be a drug answer to chronic fatigue. The true answer is in restoring mitochondrial health, with nutrients, with environmental control and environmental therapies, with self-regulation and with physical fitness.

THE STATE OF CHRONIC FATIGUE IS A STATE OF ACCELERATED OXIDATIVE MOLECULAR INJURY

My colleagues and I are conducting several research studies with our patients who suffer disabling chronic fatigue. In one series of consecutive one hundred patients, we found mold allergy caused by IgE antibodies in all cases. About 80% of patients gave histories of extensive antibiotic therapy. About one quarter of them had elevated blood levels of toxic metals such as aluminum, mercury, lead, nickel and others. Many subjects in this study suffered from unusual degrees of stress before they developed a state of chronic fatigue. Viral and bacterial infections in most cases seemed to play only contributory roles. Most of our patients respond well to our nondrug nutritional, environmental and other therapies and are able to regain most of their energy. The exceptions to this are some patients with devastating chemical sensitivity, very high levels of stress arising from extenuating personal life circumstances, and very high blood levels of antibodies to Epstein Barr virus and some other viruses. Our treatment protocols, of course, are directed to reducing or eliminating the oxidative molecular stress in the chronic fatigue state. My fairly extensive clinical and research experience with chronic fatigue leads me to conclude that it is a state of accelerated oxidative molecular injury.