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Major Update: 2/9/24

Marty Ross, MD Discusses Mitochondria Energy


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Mitochondria Create Cell Energy

It is possible to improve your energy and fatigue in chronic Lyme disease, tick-borne infections, mold toxicity, and other illnesses by improving the function of the cell power factories called mitochondria. For many with fatiguing illnesses, the mitochondria get injured and do not produce enough energy. However, there are effective steps that fix the damage and give energy back.

Mitochondria are the energy factories found in every cell in the body. By some estimates, there are nearly 400 per cell. In chronic Lyme disease or in toxicity issues, due to oxidative stress the mitochondria can be injured, leading to fatigue that will not improve. In oxidative stress, chemicals build up that can damage membranes and even the DNA genetic material of mitochondria.

As power factories, mitochondria create a type of cell fuel called ATP. The fuel sources for mitochondria are fat and sugar, and both need to be transported to the inside of the mitochondria. ATP is created when fat and sugar are burned through several chemical reactions called the citric acid cycle and another process called oxidative phosphorylation.

Transport of fat and sugar into mitochondria requires a healthy mitochondria membrane. Oxidative phosphorylation also requires a healthy membrane. When the membranes are injured through oxidative stress, sugar and fat fuel sources for ATP cannot reach the inside of the mitochondria. Electron transfer in oxidative phosphorylation that leads to most ATP production is also blocked. Mitochondria membrane injury leads to low cell ATP and thus, fatigue. 

When To Fix or Repair Mitochondria

Take steps to improve mitochondrial function if essential steps to treat Lyme do not provide good improvements in energy by 6-9 months. For these essential steps, see Fix Fatigue Boost Your Energy: The Basic Steps.

How to Improve Mitochondria Energy Production

Temporarily Patch Mitochondria Oxidative Phosphorylation with Methylene Blue

It is possible to patch electron transfer in oxidative phosphorylation using methylene blue.

The methylene blue patch leads to quick improvements in mitochondrial production of ATP. With increased levels of ATP, cells run better. This can result in improved fatigue, but it also improves thinking, brain fog, and even immune function. Usually energy improvements will occur within a month using methylene blue

This methylene blue patch does not fix the damaged mitochondria. So it is a temporary fix that you can use while you also take steps to repair mitochondrial damage I describe below. 

  • Methylene blue 25 or 50 mg 1 pill 2 times a day (this is made by a compounding pharmacy and requires a prescription). Caution: Before starting methylene blue get a blood test for G6PD. If your G6PD is low, methylene blue could break apart your red blood cells.

Methylene blue has many additional benefits. Read more about methylene blue in Mighty Methylene Blue for Tick-borne Infections and More.

Repair Mitochondria

Part A—Basic Steps for Mitochondria Repair

Below I describe four steps that you should do together during the same time period to repair your mitochondria. These four steps include

  • repairing mitochondrial membrane phospholipids,
  • increasing glutathione,
  • supplementing carnitine if you do not eat red meat, and
  • eating a mitochondrial support diet.

Step One—Fix Mitochondrial Membrane Phospholipids

In mitochondrial dysfunction, the outer and inner membranes may be injured. These membranes are composed of phospholipid fats called phosphatidylcholine and phosphatidylserine.

Healthy mitochondria membranes are needed for two reasons.

  • First, these coverings transport fat and sugar to the inside to be burned into cell fuel.
  • Second, several reactions take place on the inside of the covering, requiring electrons to be transferred to them during oxidative phosphorylation.

There are three products I suggest that include mitochondrial membrane fats. These products are all manufactured by Researched Nutritionals. These products are

  • NT Factor Energy,
  • ATP Fuel, and
  • ATP 360.

Each of these products contains types of fats shown to repair and support the mitochondrial membranes. They also include various micronutrients that support mitochondrial function.

NT Factor Energy and ATP Fuel include a phospholipid ingredient called NT Factor. NT Factor is a proprietary blend of phosphatidylserine and phosphatidylcholine made by another company. In studies with people reporting fatigue, the NT Factor ingredient is shown to improve energy at two months by an average of 40 percent. ATP Fuel contains Coenzyme q10 (CoQ10), but NT Factor Energy does not. CoQ10 should not be used in Babesia treatments that include atovaquone (Mepron and Malarone) because it interferes with their ability to kill this germ. 

ATP 360 does not use NT Factor as its phospholipid source. Instead, Researched Nutritionals includes its own proprietary phospholipid formula and delivery system. ATP 360 does include ingredients that are shown to increase the mass of the mitochondria. Finally, ATP 360 also includes CoQ10. In unpublished studies by Researched Nutritionals, ATP 360 and ATP Fuel are shown to work equally well at improving energy. ATP 360 is easier to take because it requires one time a day dosing. 

For more information, see A Comparison of ATP Fuel, ATP 360 & NT Factor Energy by Researched Nutritionals.

Suggested Dosing

You only need to use one of these products to repair the mitochondrial phospholipid membrane. Of the three products, ATP 360 is my first choice. But if you cannot take the CoQ10 found in ATP 360, then I suggest using NT Factor Energy.

  • ATP 360 3 pills 1 time a day for 6 months.
  • NT Factor Energy 2 pills 3 times a day for 2 months, then decrease to 1 pill 3 times a day for 4 months.
  • ATP Fuel 5 pills 2 times a day for 6 months.

NT Factor Energy is the only product to take if a person is on atovaquone found in Mepron and Malarone to treat Babesia.

Step Two—Increase Glutathione

Glutathione is a powerful antioxidant that repairs cell injury. It is made in every cell. Liposomal glutathione is best because it is microscopically wrapped in phospholipid fats, which increases its absorption. One can also breathe glutathione using a nebulizer, or take it by IV. The nebulizer and IV versions may work more effectively than the liposomal oral form in some patients. Read more about the nebulizer and IV versions, including dosing and how frequent to take them, in the article, Glutathione: The Great Fixer.

An alternative to glutathione is to take a building block of glutathione called N acetyl-cysteine (NAC). NAC is used to make glutathione inside cells. My preference is the glutathione, but in some cases it does not work or is too expensive.

  • Liposomal Glutathione 500 mg/5 ml take 5ml 1 or 2 times a day, or
  • N Acetyl-Cysteine (NAC) 500 mg 1 pill 3 times a day.

Step Three—Use Acetyl-L-Carnitine if You Are Vegetarian or Don’t Eat Red Meat

Carnitine is a transport vehicle that carries fat to the inside of a mitochondria so that it can be burned into cell fuel through chemical reactions. The key source of carnitine is red meat. So if a person does not eat red meat, they may not be able to fuel up mitochondria. The most absorbed and used source of carnitine is acetyl-L-carnitine.

  • Acetyl-L-Carnitine 500 mg 1 pill 2 times a day for 1 month and then 1 pill daily.

Step Four—Eat Healthy Foods that Support Mitochondria

To repair mitochondria and to boost energy, try the Mito Food Plan developed by the Institute for Functional Medicine. This diet is a modified paleo diet. For more information about this diet and how to build it for you, read The Best Brain, Inflammation, Pain, Energy, and Detox Diet Ever.

Give The Basic Steps Time

Mitochondria repair takes time. Give the basic steps at least two months to see if they will help. If they are helping, then continue this protocol for four more months.

Part B—Enhanced Mitochondria Repair

If the Basic Steps for Mitochondria repair do not give some energy improvement by two months, then I suggest stopping them and starting the peptide called BPC-157. BPC-157 is a peptide made in stomach lining. Think of BPC-157 as the Swiss Army Knife of peptides. The key ingredient may:

  • promote healthy mitochondria function,
  • promote healthy intestinal function,
  • improve leaky gut,
  • modulate healthy Th1 and Th2 immune function,
  • aid in tissue repair of joints, tendons, ligaments, and nerves,
  • balance mast cell activation, and
  • have antimicrobial effects.

Suggested Dosing

  • BPC-157 500 ug 1 pill or 2 sprays 2 times a day for a month, if no improvement in energy, then increase to 2 pills or 4 sprays 2 times a day. Take for up to six months if you are noticing improvements in your energy by two months.


The ideas and recommendations on this website and in this article are for informational purposes only. For more information about this, review the sitewide Terms & Conditions.


View Citations

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  8. Neergheen, V., Chalasani, A., Wainwright, L., Yubero, D., Montero, R., Artuch, R., & Hargreaves, I. (2017). Coenzyme Q10 in the Treatment of Mitochondrial Disease. Journal of Inborn Errors of Metabolism and Screening. https://doi.org/10.1177/2326409817707771
  9. Novakova, K., Kummer, O., Bouitbir, J. et al. Effect of l-carnitine supplementation on the body carnitine pool, skeletal muscle energy metabolism and physical performance in male vegetarians. Eur J Nutr (2016) 55: 207. https://doi.org/10.1007/s00394-015-0838-9 (View)
  10. Peptide Therapy Certification - Module I. Lectures presented at the Advanced Anti-Aging Medicine Conference; September 2022; Boston, MA.
  11. Peptide Therapy Certification - Module II. Lectures presented at the Advanced Anti-Aging Medicine Conference; December 2022; Las Vegas, NV.
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About The Author

Marty Ross, MD is a passionate Lyme disease educator and clinical expert. He helps Lyme sufferers and their physicians see what really works based on his review of the science and extensive real-world experience. Dr. Ross is licensed to practice medicine in Washington State (License: MD00033296) where he has treated thousands of Lyme disease patients in his Seattle practice.

Marty Ross, MD is a graduate of Indiana University School of Medicine and Georgetown University Family Medicine Residency. He is a member of the International Lyme and Associated Disease Society (ILADS), The Institute for Functional Medicine, and The American Academy of Anti-Aging Medicine (A4M).

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