Your Mitochondria Are Dying - Here's What Fixes Them

If you remember what it felt like to have effortless energy, to bounce back from a hard workout, and to think clearly, but now you feel like you're running on a half-charged battery, maybe you have 20 supplements in your cabinet and wonder if any of them are working. But what if you are pouring supplements into a system with dead batteries, dead mitochondria? Most people are trying to fix their mitochondria without even knowing what a mitochondria really is or how it really works. So today we're going to change that. Today I'm going to show you where your energy actually comes from, where it breaks down, and how interventions like NAD, CoQ10, fasting, and cold plunges actually target the problem. And by the end, I'll tell you the one intervention that beats every supplement on my list. I'm Dr. Ashley Frazee. I'm a board-certified primary care physician, but just remember, I am a doctor on YouTube, but I am not your doctor, and nothing in this video replaces a real conversation with your own. It's Educational only. Let's describe a mitochondria. The shape of it is actually really important. Picture a bean shape with two walls: a smooth outer wall and a heavily folded up inner wall. The outer wall is the front door to your energy factory. It's porous and fluid, which basically means that it has tiny little openings that allow fuel, nutrients, and signals to move in and out of it. Between these two walls is something called the inner membrane space. You can think of it like a loading dock, and we're going to come back to this in a minute because it will become very important. Now here's where things can go very wrong. Chronic inflammation, aging, insulin resistance, which happens when you're overweight or have diabetes, and poor metabolic health in general can change the structure of this outer membrane and stiffen it. And now things can't move in and out the way that they're supposed to. Very important signals Now have a harder time getting their messages across. Sometimes fatigue doesn't start because your mitochondria can't make energy. Sometimes it starts because of this. I call it signal interference. In other words, before we even talk about supplements that help you make energy like CoQ10 and NAD, we have to make sure the front door is actually working. The way you do this is by changing the lipid composition of this wall instead. Stopping the structural degradation that's caused by inflammation, or burning the candle at both ends. You can think of the outer membrane like a fluid security fence. If it gets packed with the wrong fats or becomes too rigid from inflammation, the gates rust up. And so my favorite thing to tell people here is to eat more antioxidants. Just think berries and colorful foods here. Also omega-3 fatty acids, fish like sardines, or supplements with high EPA and DHA. This is a big reason why these aren't important. Phosphatidylcholine. This is a supplement that you can take, but it's the primary ingredient that makes up the structure of this mitochondrial membrane. But the front door is the easy part. The second wall is where your energy is actually won or lost, and it looks nothing like the first. This is where it gets really cool and interesting. This inner membrane isn't smooth like the outer one. It's very wrinkled up. And if you learn anything, know that this is completely intentional. These wrinkles or folds are called Christi. They're like an accordion. And the reason for this is that your body takes a pretty small membrane and folds it over and over and over again to create a massive amount of surface area. Because this is where the engines for your energy live. And more folds means more room for engines. More engines means more ATP, and more ATP means more energy. According to research, healthy metabolically active mitochondria have inner membranes that are beautiful and tightly organized with very deep folds. But when we look at older, stressed out, damaged mitochondria, those folds start to flatten out. The accordion loses its shape and it can't make good music anymore. Or your mitochondria have less ATP production. Now, you may want to know which supplements fix this, and I'll give those to you, but hear me out because this is one of the very few places where exercise absolutely dominates supplements. According to research, consistent exercise is one of the strongest signals we know of for improving mitochondrial structure over time. I'm just going to let that land for a second. So just know exercise isn't all about looking good. But even perfectly folded Christie can't make energy by themselves. They still need the factory assembly line to actually make the energy. And that's where we focus next. This is the electron transport chain. Now, the electron transport chain isn't a magical merry-go-round. It's really a 5-station assembly line that lives on that folded-up inner mitochondrial membrane. If you've ever wondered how or why CoQ10 supplements work, This is the stuff that you need to know. Think again about a factory assembly line here. You have station 1, 2, 3, 4, and 5, formerly called complexes 1, 2, 3, 4, and 5. And from start to finish, when you eat food, you end up breaking it down into NADH and FADH2. Think of these as like energy delivery trucks. And something important here is that the H in both of these are hydrogen atoms. Which consists of 1 proton and 1 electron. When NADH arrives at Complex I, it drops off electrons. The electrons continue moving through the chain, the assembly line. The protons get separated and pumped across the inner mitochondrial membrane. Now you have a separation of charge and concentration, which creates stored potential energy. You can think of it like pumping water uphill into a reservoir. Lots of potential energy being made here. You get a ton of potential energy building up with the protons moving through the membrane, and eventually they rush back through complex V, which is like a turbine that spins and creates ATP or energy as long as the electrons make it down the line. So here we go. Food comes in, electrons get moved down the membrane, protons build up and eventually rush back in, which spins a turbine, and voilà. you have made energy. That's the process. Unfortunately, complex 1 is where most damage occurs from age and inflammation, just like the outer membrane. And now this is where some supplements can enter the story. CoQ10's job is to help shuttle electrons through this assembly line. It's basically helping traffic move through the power plant. Statins, our famous cholesterol medications, can block your body's natural production of CoQ10. And that's why we recommend supplementing with it if you take statins. The popular supplement methylene blue, which arguably a lot of people don't understand how it works, well, it can actually help pick up electrons that can get stuck in damaged complexes and continue moving them along the assembly line, which is really cool science. The goal here isn't to create ATP directly. The goal is to keep the assembly line moving efficiently. But the engine isn't always the problem. In fact, where a lot of damage actually starts is in the center of the mitochondria, past the inner mitochondrial membrane. This is where the mitochondrial matrix is, which is like the soup in the middle. This is where your food actually gets processed. So remember the energy delivery trucks we just talked about, NADH and FADH2? Well, this is where most of them get loaded up with their cargo. The matrix contains the Krebs cycle or the citric Acid, or TCA cycle. Push that all aside if that just created some trauma for you, but this is where all of that happens. This is where your food gets broken down into the NADH and the FADH2. You eat food, the Krebs cycle breaks it apart, and then in return it loads up those little delivery trucks with cargo that can be delivered to the engines. Anyway, it's here that supplementation with NAD can be useful. So a lot of people think taking supplements for NAD creates energy out of nowhere, but it's really just support for the assembly line. NAD eventually becomes NADH, one of the main energy delivery trucks feeding the electron transport chain. Now for a fun fact: most of our DNA lives in our cell's nucleus, but the mitochondria, despite living outside of the cell nucleus, actually has its own DNA. Unfortunately, this is also where damage starts accumulating. Remember the engines we just talked about? Well, they're incredibly efficient, but they're not perfect. About 1 to 2% of the oxygen that gets moved through that system leaks out and creates something called reactive oxygen species, or ROS. And you can think of reactive oxygen species like tiny little sparks flying off of the machinery. A few sparks is totally normal and fine. In fact, your body actually uses small amounts of these sparks for signaling and adaptation. But if the sparks are constantly flying everywhere from excessive stress, illness, inflammation, poor diet, bad sleep, you get the picture. Well, everything starts catching fire. And over time, excessive reactive oxygen species can damage the mitochondrial DNA. It can damage the Christie and even damage parts of the engine itself. And this is one of the reasons that aging is a very vicious cycle. More damage creates more dysfunction. More dysfunction creates more reactive oxygen species, and the cycle keeps feeding itself. I could stop here, but this next part is actually a big deal. See, your mitochondria aren't permanent workhorses. You're actually supposed to kill off broken ones and build new ones constantly. The process of recycling mitochondria is called mitophagy. Literally translated, it means eating mitochondria. So your cells identify damaged mitochondria, tag them for removal, break them apart, and recycle the useful pieces. It's basically controlled demolition. The sad thing is that as we age, become more sedentary, and develop metabolic dysfunction, well, that cleanup process starts slowing down, and suddenly the broken mitochondria stick around and create a whole bunch of inflammatory byproducts. And instead of a factory full of efficient workers, now you've got a bunch of malfunctioning equipment hanging around just collecting paychecks. Interestingly, those dysfunctional mitochondria can create even more dysfunctional mitochondria. So the problem really starts compounding over time. Now, if mitophagy is the demolition crew, your body also needs ways to make new mitochondria, and that's called mitochondrial biogenesis. Biogenesis literally just means creating new life, or in this case, building new mitochondria. The master switch controlling a lot of this process is called PGC-1 alpha. And when PGC-1 alpha gets activated, your cells get the message, hey, we need more power plants. We need more mitochondria. So if you think about all the biohacks that we're interested in, exercise, fasting, cold exposure, even higher NAD levels and certain peptides, well, these can all help activate mitochondrial biogenesis. And this is where one of the most popular mitochondrial supplements that not a lot of people understand comes in, urolithin A. So urolithin A is a compound that you actually make through your gut bacteria when you eat foods like pomegranates. And what's cool here is that researchers have been studying it because of its effects on mitophagy. And the research suggests that it helps your body identify and remove the mitochondria that shouldn't still be there. And see, if you're just trying to supplement for mitochondrial health and you don't actually know what you're targeting, it can kind of get messy. So know that if you're using urolithin A, this is what you're doing. You don't always have to focus on boosting the engine. Sometimes you do need to focus on mitophagy and then boosting the energy. But I think it helps a lot to know what you're doing. And now I hope you can see why there isn't one best mitochondria supplement. There's just different interventions that target different parts of the machine. If the membrane's the problem, think omega-3s, phosphatidylcholine, and improving metabolic health. If the inner mitochondrial membrane is flattening out, exercise is a very big deal here. There are also peptides that can kind of stabilize that, but that's another subject for another day. If the engine is slowing down, well, that's where CoQ10, riboflavin, and potentially methylene blue fit. But please talk to your doctor about that one, and if they don't know, at least watch my videos around that. If the matrix needs support or you just need more NAD+, well, that's where supplements like NMN, like this one, enter the conversation. And if you want the link for this one in specific because it's my favorite, you can get the link for that in the description. If quality control is the problem, that's where urolithin fasting, cold exposure, and also exercise can help remove mitochondria and build new ones. So I'm hoping that by now, instead of throwing random interventions at your mitochondria, you know exactly which part of the machine you're trying to fix when you hear all about these mitochondrial supplements and peptides. And hopefully now you understand why this is all so important. And now that you understand the anatomy, the next question is the obvious one: what's actually destroying yours in the first place? And I broke that one down in a whole video that you can see next. I'm Dr. Ashley Frazee. I spend a lot of time thinking about what goes on inside our bodies. It's just the best way for me to understand what we need to be doing and how to fix things. If you like this video, please hit like for me, subscribe to my channel, and I'll see you in the next one. I hope you have the best day.