The first part of the question is easy to answer for readers who vicariously make periodic visits to the planet Tatooine in a “galaxy far, far away.” There, “intelligent microscopic life forms called Midi-chlorians live symbiotically inside the cells of all living things.” In that far away galaxy, midi-chlorians are essential for life and provide communication with the pervasive energy field known as the Force. High amounts of midi-chlorians are possessed by the Jedi, warrior monks who serve as guardians of peace and justice in the galaxy that includes Tatooine. The higher the midi-chlorian content the greater the link to the Force. Readers who know of midi-chlorians will find that mitochondria are familiar creatures.
For less enlightened earth-bound humans, the answer is a bit more complex. Like midi-chlorians, mitochondria are believed to have once lived as independent single-cell organisms that now dwell in a symbiotic relationship within larger living cells. Like midi-chlorians, mitochondria still maintain some independence by holding on to a little of their own DNA. Without mitochondria, as without midi-chlorians, “life could not exist and we would have no knowledge of the Force.”
Mitochondria, which are appropriately partnered with the Force, are exquisitely small powerhouses that provide for the energy needs of living cells. There can be less than a few hundred or more than a few thousand mitochondria in a cell depending upon the cell’s energy needs. Heart, muscle, and brain cells contain the greatest number of mitochondria because of their high energy demands. However, providing energy is only one of many mitochondrial functions. As will be seen as this book unfolds, mitochondria play numerous and varied roles of significance in life process.
Part One: The Force
The first part of Life is titled The Force. It provides a thorough review of technical details that relate to cellular biology, mitochondrial structure, and energy production. This information requires clarification in order to communicate more effectively the basics of mitochondria and the requirements for their care and nurture presented later in the book. The subjects in the first part that are most valuable for refreshing professional memories will probably be the same as those that are most difficult for the lay reader. These subjects are oxidative phosphorylation and the electron transport chain. They describe mitochondria’s primary function, which is to convert energy contained in food to biochemical energy that can be used by cells for growth, maintenance, and repair.
The author recognizes that these are difficult subjects not easy to explain in lay language. A comprehensive glossary at the end of the book will benefit the patient reader, but if patience wanes, the reader would do well to heed the author’s suggestion: “If I lose you with the details, don’t get tied up in a knot; just try to understand the big picture.” Above all, do not give up. You will be rewarded greatly with useful and practical information in the remaining two parts.
The remainder of the first part continues the discussion of mitochondria including the role of mitochondria in regulation of cell death, the influence of mitochondria on life span, the mitochondrial theory of aging, and the fascinating story of mitochondrial DNA. Mitochondria are the only organelles in a cell that possess their own DNA.
The mitochondrial DNA story tells that when the legendary mitochondrion of prehistory was engulfed by a much larger cell eons ago, a symbiotic relationship developed, and the status of the mitochondrion’s DNA slowly began to change. Some genes were lost, some were kept, some were changed, some were mutated, and some were transferred to the host’s nucleus. The genetic pattern of today’s mitochondria is the product of the sum of these evolutionary changes; overall, they have kept some genes and lost some genes. The DNA story ends with an interesting discussion of why mitochondria need genes at all.
The first part ends with an explanation of a little known function of great significance for mammals; the uncoupling of energy production. The result is the production of heat, which utilizes specialized adipose tissue known as brown fat (an excellent description of the manipulation of brown fat to increase expenditure of energy can be found in the section Massage and Hydrotherapy, Part Three).
The ability to release energy as heat when energy demand slows is not only protective of the integrity of mitochondria but it also prepared the way for the evolution of warm-bloodedness. Without mitochondria “…warm-bloodedness would never have evolved, and we’d likely all be enjoying a reptilian lifestyle, with all its limitations”
Part Two: The Dark Side of the Force
The second part of Life is titled the Dark Side of the Force, which refers to adverse health consequences associated with defective or compromised mitochondria. The diseases discussed are wide-ranging, affect essentially every tissue, organ, and/or system of the body, and stress the importance and central role mitochondria play in health and disease. In preparation for the discussion of specific health conditions, there is a brief reminder of the three fundamental requirements vital for mitochondrial health; ATP, food, and oxygen.
First, the primary role of mitochondria is to produce chemical energy in the form of ATP. The production of ATP begins with delivery of the products of digestion of food (primarily glucose and fatty acids) into the matrix of the mitochondria. Within the walls of the mitochondria, a complex series of highly structured biochemical reactions transfer electrons stepwise along an electron transfer chain assembly line from food to ATP. ATP is the acronym for adenosine triphosphate, a biochemical that stores and transports chemical energy used to support cellular life functions. ATP is the universal chemical energy source for all life forms from the simplest to most complex.
In order to produce ATP, the mitochondria require food and oxygen. The author’s words “As long as each cell is provided with two basic ingredients – electrons from food, and oxygen from the air we breathe – this cycle occurs unimpeded million of times per second in every cell of the body…if either of these two basic ingredients are in short supply relative to demand, cell function is compromised” underscore an extremely important message for scientists who are reluctant to accept the fact that unhealthful dietary patterns are a cause of chronic disease. Essentially all chronic inflammatory diseases are due to lack of sufficient quantity and/or quality of fuel and materials (macro-and micronutrients) required for the body to self-heal.
The discussion of diseases begins with those that are probably of greatest interest to most readers: cardiovascular diseases; nervous system, brain, and cognitive disorders; and type 2 diabetes. The interactions between mitochondria and disease states are difficult to categorize; the number of critical steps in mitochondrial function combined with differences among diseases in vulnerable sites for contact with mitochondria preclude simple classification. Nevertheless, the foregoing discussions provide priceless information not only for the reader but also for the healthcare provider and the physician. An interesting bit of information, which will probably surprise most readers, is that there is a disease known as mitochondrial diabetes!
The next section of the second part presents a table of medications known to cause mitochondrial damage and disease. The table includes just about every class of drug with names of individual drugs listed for each class. The mechanisms of damage are briefly discussed. This section gives tacit credence to the saying that there is no drug that will cure a nutritional disease.
In addition to mitochondrial diabetes, a fairly long and comprehensive discussion of all aspects of mitochondrial diseases follows next. These are diseases that are due to mutations in mitochondrial DNA. These diseases, essentially unknown before the complete sequencing of the mitochondrial genome in the early 1980s, are becoming more and more recognized as genetic testing becomes more readily available.
It is estimated that about 1 in 5000 people are born with a mitochondrial disease. Thus, this very important discussion should be studied by healthcare providers and physicians. It may contain explanations for unexpected, inconsistent, or lack of results that occur during standard treatment procedures for known disorders. A remedy that is unknown or unrecognized is a remedy that, for all practical purposes, is nonexistent.
The second part ends with the following brief reviews: age-related hearing loss; ageing skin and wrinkles; infertility; eye-related diseases; stem cells; cancer and ageing. It is difficult to believe that any reader, scientists included, would not find something of value in Part Two.
Part Three: Nurturing the Force
The third part of Life is titled Nurturing the Force. It discusses the nutrients needed to preserve the health of mitochondria and restore health to those that are compromised. It is the section that probably is the one of greatest interest to most readers. The average lay reader feels inadequate when trying to wade through unfamiliar scientific words and concepts. Thus, there seems to be more interest in writings that tell the reader what to do rather than explain the reason why. For all readers who are starting the book here in Part Three, you are doing yourself a great disservice. The time spent on reading the first two parts of the book will greatly enhance appreciation of the delicate and vital workings of mitochondria and how they can be protected.
Probably the most pressing problem faced by mitochondria is damaging free-radical leakage caused by electrons escaping from reactions along an electron transport chain. The difficulties of methods for reducing escaping electrons are reviewed with the conclusion that the only method currently available to prevent the problem is by calorie restriction, the mechanism of which is discussed in the later section Ketogenic Diet and Calorie Restriction.
In the interim, however, there are remedies that can be employed to support and/or enhance the health of mitochondria. The first nutrient mentioned, D-ribose, is given particular attention because of its special benefit for endurance athletes who experience athletic heart syndrome and patients with cardiac disease. D-ribose is a 5-carbon sugar that the body makes from glucose by a pathway known as the pentose phosphate shunt. D-ribose is known primarily as a major component of DNA and RNA molecules, but its importance for mitochondria is as a precursor of ATP. The large energy demand (ATP) by heart tissues often cannot be supplied rapidly enough by compromised mitochondria. The supply of ATP can be more rapidly restored by supplementing with d-ribose. It is effective in restoring energy efficiency in any cardiac condition.
The next nutrient discussed is PQQ, which stand for pyrroloquinoline quinone. PQQ is an exciting biochemical that is under consideration for status as a vitamin. It has recently been found not only to protect mitochondria from oxidative damage but also to stimulate growth of new mitochondria. PQQ is widely distributed in foods, a table of which is presented on pp133-134. More exciting is our surprise to find PQQ mentioned in Life. The discovery of PQQ’s importance was only made in 2010. Anyone familiar with book publishing will recognize that the latest information mentioned in any nonfiction book is usually a few years old.
After PQQ, there follows in order: Coenzyme Q10; L-Carnitine; Magnesium; Alpha-Lipoic Acid; Creatine; B Vitamins; Iron; and Resveratrol and Pterostilbene, each with information about relationship to mitochondria. The remainder of Part Three deals with practices that may benefit mitochondrial function. The first subject is ketogenic diets and calorie restriction, which are briefly described as showing some promise for slowing down the aging process, boosting cardiovascular and brain health, and delaying or perhaps even preventing some major chronic inflammatory diseases. The author warns that self-prescribing a keto or calorie restricted diet should not be undertaken without a lot more study of them in order to know what you are doing.
The final section is a very interesting treatise on exercise and physical activity that is a must for everyone to read. “Best for last? Exercise and physical activity is the last topic but probably the most important when it comes to mitochondrial health.” The balance of this section describes and explains the Exercise Paradox.
There probably will be cheers and jeers for the guidance suggested in this section. Diehard members of the fitness culture who live in gyms or exercise parlors and glory in their sculpted abs will vigorously dispute the conclusion that “strenuous, exhaustive exercise is not good.” Nevertheless, it is a reality that the greater the demand for energy, the greater the production of electrons, and consequently the greater the mitochondrial damage by free radicals. Therefore, although strenuous exercise may be harmful to mitochondria, being sedentary is no better and may be worse.
The question of benefit remains for moderate exercise, both aerobic and resistant kinds, because any exercise or activity increases the rate at which free-radicals are produced. Should all exercise and physical activity be discouraged? The emphatic “No” will elicit cheers from the balance of the fitness folk who are not so obsessive about exercise. The balance of this section spells out the numerous beneficial effects of moderate exercise and physical activity that far outweigh any troubles caused by free-radicals.
In pulling it all together, the author notes that study of mitochondria is a fascinating subject that is constantly and rapidly evolving. It has “…real life implications for countless health conditions, and indeed life and death itself.”
May the Force be with you.
Thank you Dr’s Fred and Alice, for this informative post.
The ‘add ons’ of these supplements will be powerfully effective or much like the thousands of supplements that are of little importance.
Over the years, I have taken all (apart from PQQ).
The only one that I could measure and see a profound positive effect, was D Ribose. The observations on my ‘fasting blood sugars’ was remarkable. Did not test for ‘post postprandial’.
Have just ordered these supplements on line. Apart from blood sugars, I guess the only guide may be an improved feeling of well being. But then again it may not be apparent, even though the mitochondria may be enriched.
On the subject of ‘exercise and physical activity’ I totally agree with the approach. Over the years I have noticed that the ‘heavy exercisers’ seem to be aloof and not in the moment.
You raise a very good point, Michael. When you start a new supplement, it is often difficult to tell whether it is having a beneficial effect or not. Most supplements do not have an immediate effect, but take a few days or weeks to work. That is why it is a good idea to keep a record of when and what you take – and of course study the pros and cons of any supplement before you take it.
Obviously, if a supplement seems to make you feel worse, stop taking it. If a supplement seem to provide no benefit, stop it for a while to see what happens.
Of the supplements recommended by Dr. Know, one that is an absolute must for people who take statin medications (for cholesterol reduction) is Coenzyme Q10. Statins inhibit the biosynthesis of Coenzyme Q10, which is essential for production of energy, Deficiency of Coenzyme Q10 results in feeling of fatigue and can result in congestive heart failure.
Good luck with your new supplements. Let us know how you do.
Hello Fred and Alice, I thoroughly enjoyed reading this book. My wife Kaye has been taking d-ribose now for about 2 weeks in an attempt to lessen muscle cramps associated with her RA, something which her Dr seems unable to deal with. She shows significant signs of improved energy already and her BP has dropped to the point of no longer needing medication. Hew friend with A-fib is also taking d-ribose – your thoughts on this would be appreciated.
Hi Lew,
How great to hear from you! It is even “more great” to hear about Kaye’s benefit from supplementing with D-ribose. Dr. Know’s explanation of the biochemistry of D-ribose is so beautiful (page 122ff): The supply of cellular energy (ATP) can be rapidly restored with D-ribose. It should be effective in any cell with high energy demand. Is it helping her friend with atrial fibrillation?
Your message makes us very happy, Lew. It is testimony to the fact that when the body is given the nutrients it needs it, it will heal itself.
Thank you so much for sharing this wonderful news.
What an outstanding book! And such an easy read for such a technical subject. Thank you for the recommendation! Time to get back to brisk walks at lunchtime, now that I have a much better understanding why they’re good for me.
Hi Katherine
Thank you very much for taking the time to write and tell us of your experience. Your kindness will be helpful to many other readers.
We think the discussion in the book of the relationship between exercise and mitochondrial function is an extremely important subject for both fitness folk and couch potatoes to understand.
Thank you Alice & Fred for such a thorough review of my book! The effort that it must have taken to compile and write this is humbling in itself. Please accept my sincere appreciation for this, and all that you do to promote the message of health for you’re readers and the public at large.
I’m also happy to read about both Michael and Lew’s positive experience/feedback with some of the nutrients I covered. It’s always rewarding to learn about these, and/or hear that other’s prior experiences reflect the suggestions I mention.
I hope everyone here can experience amazing health and longevity and I’m grateful for the chance to “meet” such engaging kindred spirits. Looking forward to connecting more!
Lee
Hi Lee
Thank you so much for your kind words. Your book was a joy to read and, thus, very easy to talk about. It gives us great pleasure to know we would be helping introduce LIFE to a few more people whom we know will benefit from your knowledge of mitochondria.
It is we who should thank you, Lee, for explaining so clearly the workings of these marvelous little ovens and their tremendous importance to our health and well being. We are grateful to you.
We wish you every success in your practice – and with your most helpful book LIFE.
(Any more books forthcomming? Let us know.)
Hi Lee
Apologies for not replying sooner…..the reason being:
That I started this protocol only 4 weeks ago, and had no feedback to offer.
Apart from my 9 ‘Cardiac medication’ and standard supplements.
I have introduced:
(1) D Ribose 5 grams
(2) Creatine 4 grams
(3) L carnitine 500 mg
Also addition of:
(1) COQ10 approx. 200 mg which I have taken for over 15 years..to allow for ‘statin’ depletion.
(2) NAC
(3) Vit C 1-4 grams
(4) Niacin/B3/ nicotinic acid 1-4 grams.
Current observations at this early stage:
(1) Circadian rhythm…marginally improved.
(2) Blood sugars….steady and no remarkable improvement that I noticed with D Ribose many years ago. Perhaps becoming more resistant with age.
(3) Bowel movements….moderately improved. Without change to nutrition.
(4) Body odour/perspiration….this is quite remarkable. Have never ever had BO. So! An optimistic assumption could infer….’Expelling toxins’. It is my understanding that expelling toxins is mainly through ‘Breath/lungs’, ‘Skin’, and ‘Bowels’.
Will update in a few months (God willing), with more definitive results.
This book looks fascinating, especially with all the discussion of the mitochondria in the paleo and ketogenic community it would be great to read someone with no dogma’s outside view on it all.
Hi Alex, you are right. The story of the mitochondria is fascinating. And we found your story to be inspirational for young people planning their future.
We enjoyed your story (http://www.evolvenutritionaltherapy.com/about-me/) about finding a career in nutritional therapy. Your dedication to the study and practice of healthful nutrition and your goal to help people with nutritional problems, especially children with food intolerances and food allergies, are admirable. LIFE should be a valuable resource for you.
You will find that LIFE is about as current as a textbook can be. That was one of the things we liked about the book; it included information on some fairly recent mitochondrial research that we had recently read about in the scientific literature.
We wish you great success in your worthy profession
Fascinating read – I actually finished it in one day (truly could not put it down) and am still referencing it constantly.
Thank you, Desiree
It is very kind of you to take the time to write such a nice comment about LIFE. It is heartwarming for an author to receive compliments from readers. We are pleased that our review brought the book to your attention.
Because LIFE contains a great deal of information of value for mitochondrial health we find. like you, that we refer to the book often. That is why in our Amazon review of the book we recommended “For your desk, not your bookshelf”
A year later I am re-reading this book and getting so much more out of it after boning up on the underlying biochemistry and paying more attention to mitochondria-related issues. Thank you so much for the recommendation! This time it really caught my attention about how important something like d-ribose would be after a heart event. Something to keep on hand because of the unlikelihood it would ever be mentioned by a physician. It’s very discouraging to see so many examples of conventional care utterly failing when the information is out there.
I’m still gratefully in a preventative mode. My last bloodwork was proclaimed excellent, and what I have learned here is definitely part of the reason.
Thank you. Katherine, for a really inspiring observation. You are to be admired for the time you devote to learning how to care for your health and well being. We were delighted also by your insightful comment that you are in a “preventive mode,” because it is real and is actually the result of your study.
Few people realize that the remarkable machine known as the human body can actually heal itself IF given the proper nutrients. For people who are already in a state of good health, the proper nutrients will also prevent chronic diseases by preventing the chronic inflammation that is the cause of chronic diseases.
We were happy, too, that you rediscovered D-ribose. D-ribose is a 5-carbon sugar that is used to make the energy (ATP) required for life processes. D-ribose is made from glucose; therefore, people on a low- or no-carbohydrate (glucose) diet should supplement with D-ribose to make up for the lack of glucose. A deficiency of D-ribose can result is a deficiency of ATP, which can result in varying degrees of fatigue.
Keep up your good work, Katherine, and you will protect and extend indefinitely your healthful “preventive mode.”
I am confused by the comment ‘people on a low- or no-carbohydrate (glucose) diet should supplement with D-ribose to make up for the lack of glucose’, because I thought the whole point of a keto diet was to force the body to use fat as a fuel source. If you take D-ribose, doesn’t it undo that?