health, healing and illness

The Exquisite Simplicity of Health and Illness: Mitochondria and Energy

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For years I have struggled to get people to understand the relative simplicity of what causes us to get sick. Our medical model implies that each disease has a specific cause, and therefore, has a specific treatment. If you look seriously at what makes us tick, there are several obvious factors involved. Yes, we are provided with a “blueprint”, given in code called DNA, by our parents. Since the discovery of DNA, medical research has emphasized almost to exclusion of other factors, that genetics is the primary research area. The most amazing recent finding is that our cellular genes (the blueprint) can be manipulated by our diet and lifestyle.

Diet and Stress

Even though the great Hans Selye studied the effects of physical stress on animals, we have neglected it in relationship to human health. He said that humans were suffering from what he called the diseases of adaptation. What he meant by that was that any form of “stress” has to be met by an adaptation that requires a huge amount of energy. The brain causes the body to go into a defensive mode when we are attacked by a microorganism and it should not be surprising that it requires energy. Sometimes a severe form of stress is associated with fever that should be regarded as an automated defensive action. In fact, I knew of a patient in whom the cause of her persistent fever could not be determined by standard laboratory methods. It was written off as “psychosomatic”, because of personality factors.

The idea, however, seems to me to be a reduction to absurdity based on collective ignorance of the underlying mechanism. The symptoms that we develop are caused by all the actions that make up the defensive mode and we call that the disease. For example, fever is part of the defense because it renders the attacking organism less efficient. Hence, the attacking organism is a “stressor”. Perhaps prolonged mental stress can produce fever in a metabolically abnormal brain because of causative misinterpretation by the brain.

It has long been time-honored that we bring the temperature down artificially as part of the treatment for infection, thus losing an important part of the defense. It wasn’t the flu virus that caused Reye’s syndrome, a disease that caused the death of many children. It was the aspirin given by the mothers to bring their child’s temperature down.

Energy Deficiency and Mitochondria

When you read a telegram giving you bad news, when you ride a bicycle, when you run cross country or shovel snow, we take it for granted that the energy will be forthcoming, that is if we think about it at all. Energy deficiency in the heart muscle could easily explain the “drop-dead” phenomenon occasionally experienced by elderly people in the winter when shoveling snow, usually written off as a heart attack from coronary disease that could easily be part of the event. Could that death have been prevented by analyzing the state of nutrition for that individual?

Another great discovery is that we have a separate set of genes that preside over the functions of our mitochondria. These are the organelles within each of our cells that produce the energy that enables us to function. Sick mitochondria produce sick people, because energy consumed must be met by energy synthesized. We now know that mitochondria have their own genes completely separate from the “blueprint” genes. Mitochondrial genes are passed to the children by the mother. When damaged mitochondrial genes are passed on to children, it becomes a form of maternal inheritance. An obvious question is whether the damage to genes can be caused in adult life from malnutrition or whether the damaged genes passed on to the children are invariably inherited from grandma.

Energy synthesis depends upon an exquisitely complicated set of nutrients that are derived from what we eat, so nutrition becomes the third factor. It is therefore very likely that an element of each of these factors is always involved. Yes, it is true that a genetic mistake may be the primary cause, but a lot of genetic mistakes are really risk factors that begin to produce a given disease in relationship to “stress” and “nutrition”, both of which always play a part.

We now know that the induction of the first symptoms of beriberi, a well-known vitamin deficiency disease that has dogged mankind for centuries, can be fully initiated by sunlight exposure in a person with marginal deficiency. There may be mild symptoms attributed to other “more acceptable” causes or even no symptoms of vitamin deficiency prior to sunlight exposure. In the early investigation of beriberi, the appearance of symptoms in many individuals at the same time misled the investigators who concluded that it was due to a mysterious infection. We now have reason to believe that ultraviolet light imposes a “stress” in an individual whose metabolism is marginal, thus initiating the true underlying cause.

Healing Comes Naturally If We Let It

The human body, as we all recognize, is beautifully designed and healing is a natural phenomenon built into our system. The body knows exactly what to do, but like stress factors, healing requires energy. So, it seems to make absolute sense that we cannot possibly produce healing by the use of compounds that are completely foreign to our cellular system. Shouldn’t we be using methods that assist the healing process by stimulating mitochondria to produce the necessary energy? Surely, the only possible assistance must be through the use of nutrients. At present, we know that there are well over 40 separate non-caloric nutrients that we must get from our food to maintain health and this may not be a full complement.

Feeding the Body Fuel to Heal: Of Vitamins and Minerals

I give this as a forerunner to news that I came across quite recently. I am reasonably sure that it will be known by people who love American sports. Everyone knows the name of Bernie Kosar, the great quarterback of the Cleveland Browns back in the good old days. Bernie understood the highs and lows of football. He had hundreds of concussions, broken bones and torn ligaments over 8 ½ seasons. In retirement he suffered pounding headaches, sleepless nights, anxiety and increased weight. Speech slurring made people think that he was drunk. Amazingly, his family didn’t believe that he had genuine symptoms and thought that he was merely trying to gain attention. The slurred speech was thought to be due to alcohol, the weight gain from overeating. After his retirement, apparently he spent some time in Florida and he learned there of a physician who was using intravenous vitamins to treat the kind of symptoms of which he complained. He tried it and immediately began to feel better. In fact he was so impressed that when he came north to live in Ohio he looked for a physician who could continue this treatment. He was directed to a doctor Pesek, founding holistic physician and CEO of Vital Health in Cleveland, Ohio. Dr.Pesek uses holistic superfoods and megadose vitamins to treat his patients. Kosar gets two or three intravenous infusions of vitamins a month. His headaches have decreased, his sleep is improved and he has lost 60 pounds in weight. This is loss of accumulated water in the tissues, a signature of  mitochondrial disease, not loss of fat. In fact he is so impressed that he is going to bring it to the notice of the NFL concussion settlement. He wishes that he had started it earlier. He says that “he knows of guys who are older and some who are younger than me and it goes south quickly”.

Healing the Brain

Because the methodology is “out of the box”, it is likely that a common explanation would be the so-called placebo effect. But that effect has to have a mechanism and perhaps the approach with nutrients actually stimulates this effect. What we know about brain injury is that the damage upsets the normal balance of metabolism. It causes a release of oxygen radicals, a phenomenon that can be likened to the production of sparks in a fire. The damage is cumulative, eventually giving rise to the kind of symptoms experienced by Kosar and also by Mohammed Ali, who went on to suffer from Parkinson’s disease. Neglect the early symptoms, almost always mistaken for psychosomatic disease, and the damage slowly accumulates, eventually becoming irreversible and untreatable. I suggest that this is represented as one of the many neurodegenerative diseases such as Alzheimer’s or Parkinson’s. Under the present medical model, it might easily be assumed that intravenous vitamins are a specific treatment for the effects of concussion and should be reserved for that. The point is that there are many avenues to metabolic imbalance. For example, if type I diabetes was determined by a genetic effect, why do the symptoms not appear for many years?  If genes are solely responsible, diabetes should be present at birth. The answer is that other factors come into play including malnutrition and aging. In fact, in the state of genius, it might be that even the best possible diet does not provide sufficient energy, perhaps explaining the long-term illnesses of the historical figures, Mozart and Charles Darwin, both of whom suffered lifelong from symptoms that have often been regarded by historians mostly as psychosomatic.

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This article was first published on July 31, 2017.

Derrick Lonsdale M.D., is a Fellow of the American College of Nutrition (FACN), Fellow of the American College for Advancement in Medicine (FACAM). Though now retired, Dr. Lonsdale was a practitioner in pediatrics at the Cleveland Clinic for 20 years and was Head of the Section of Biochemical Genetics at the Clinic. In 1982, Lonsdale joined the Preventive Medicine Group to specialize in nutrient-based therapy. Dr. Lonsdale has written over 100 published papers and the conclusions support the idea that healing comes from the body itself rather than from external medical interventions.


  1. Hi Dr. Lonsdale,
    Thank you for all your work on this subject! I have several questions:
    1. Do people who have trouble detoxing mycotoxins actually have thiamine deficiency, rather than the HLA gene theory proposed by Dr. Ritchie Shoemaker? (HLA not recognizing antigens and body stores them instead of detoxing)
    2. Do people with eczema often have thiamine deficiency?
    3. What company do you recommend to get thiamine from?
    4. Do people need to stay on megadoses for life if they don’t have any familial beriberi or rare genetic thiamine disorders?
    5. Could mutations that show up on genetic tests really be mitochondrial dysfunction, and once that is corrected, you would have different genetic test results? (I ask specifically about keap1 and nrf2 genes)

    Thank you very much! Any answers or advice would be greatly, greatly appreciated!

  2. Can anyone please help or relate??

    I started taking Thiamine HCL end of March and had paradox for a month before stabilizing and seeing some improvement. I stopped taking it for a few days ahead of a medical test I was going to have and then resumed. A week ago (beginning of June) I stopped taking it because I was taking a few supplements and just wanted to start again with just thiamine so I stopped everything for a week (quercetin and aged garlic capsules with the occasional Vit C and rarely zinc gluconate).

    Once I stopped, I started to feel worse than I felt before i started taking Thiamine. I was very agitated and had severe anxiety before starting thiamine but when I stopped thiamine I was full on suicidal and more agitated than ever. Why? Is my brain now dependent on thiamine? Why do I feel worse than before i even heard of Thiamine? This is scaring me and I’m afraid I messed myself up even more than before.

    And please no one suggest anything about magnesium. I tried so many types when I first started taking thiamine and they all made me severely anhedonic and depressed sometimes to the point of wanting to die. I tried so many different types and they all did that so I stopped all magnesium.

  3. Thiamine makes me smell weird. Its probably the sulphur. Is there a solution to this?
    Big thanks to both of you for sharing your knowledge!

  4. There are thousands of diseases, but just one health (Ludwig Börne, apparently Juda Loeb Baruch)

    There are many tests, but the test which matters really, is how much watts per kg body weight at the level of 1.5mMol lactic acid can be made. (Endurance) (Heinrich Bergmüller, he understands something about muscle!)

    Indurain 1h 530 Watts / 78 kg
    Armstrong 1h 500 Watts / 70 kg
    Pantani 1h 460? Watts / 60 kg
    If all of them were doped, I don’t know-but still impressive.

    When I was doing 380W/with lactic acid 6.5 for 2 minutes, with 108 kg, the doctor said it was record.
    Probably my Thiamine and Acetyl CoA were just low midfield?(as the level of understanding of this doctor at that time?)

    For short distance running ADP to ATP reconversion through creatine-phosphate matters too.

      • Thanks for taking the time to answer me, Dr Lonsdale.

        I’m just afraid it will harm me being so bitter and potent.

        You’ve mentioned your connection to the manufacturer before, you don’t have a deal with them do you?

        I know it is incredible rude to mention but your associate Elliot is making big money on thiamine and your book is incredibly expensive. So I guess I’m just questioning things I guess.

        • Roland, I just had to respond to this comment because it is in fact rude and ill-considered. I’d like to point out a few things about the book. You say it is expensive, but what is a lifetime of knowledge worth? Should it be free? Or maybe or maybe $10, $15, less than a meal out, less than the hundreds or thousands of dollars most folks spend on entertainment every year? Less than most spend at Starbucks in a week? That is really what you are asking right, that a lifetime of knowledge cost less than a night out the movies.

          Have you considered what it costs to accumulate this knowledge and then take the time to write about it. This book took a year to write. A year. A year of full time writing that was not paid. What do you think a years worth of work should be worth? Should that be given away freely as well? Now let us consider what publisher takes from the authors of this book. I bet you didn’t know this, publishers takes 90% of the cost of a book. That means that each of us makes about $4 for each book sold. And while sure we might sell more books if it were $15, nowhere in this equation does this type of book make money for the authors. So now, tell me what you think we ought to charge for this book.

          Secondly, Elliot purchased, read, and was impressed by the book. It answered many questions about clients he was seeing. He found that thiamine solved many of their health issues and decided to build awareness about thiamine deficiency. He did this independently. Eventually, he and I met via email and then via the skype interview which has been circulating on YouTube. In our discussions, he recognized a lack of excipient free TTFD thiamine supplements on the market and the difficulty in getting TTFD to the UK where he was located. He decided to fill that need. All of this was independent of us but inspired by the book. Is he making big money on these supplements? I doubt it, but I do not know. What I do know is that he works his butt off helping people to recover. Should he be giving all of this away for free too?

          And finally, have you not recognized that you are commenting on a website which contains a lifeline of information for folks like yourself and that is available for free? Did you know that all of the writers volunteer their time, including myself and Dr. Lonsdale, to provide critical health information to the public? Have you noticed that you are commenting directly with one of the world’s most renowned experts on the issue of thiamine, who is willingly giving his time to respond to you and others for free? No, you probably didn’t. And with all of this, with the potential to understand your illness and possibly recover, you are complaining about the cost of a book and the presumably the cost of the supplements. Do you not see the irony in this?

          While I understand that you are ill and likely frightened at the prospect of continued illness, and that these comments may have come out of that fear, I find comments like this, which are all too common, entirely disrespectful and endemic of why so many people are ill in the first place. We want everything for nothing, failing to realize that health takes work. It takes knowledge and commitment. Those things have a cost in time, in struggle, and in money. Ill-health does not come by accident. It is an accumulation of not recognizing the costs of the decisions we make, of the food we eat, the medications we take, the lifestyles we engage in. It is an expectation that health is free. It is not.

          • I am sorry if I offended you. I’m just guarding my health here. I do appreciate all the free service you provide here and your patient interaction with laymen.

            There are, however, doctors (in this industry) pushing high dose supplements that they have patented.

            For example two doctors pushing 50 mg iodine a day recommendations with books and patented pills (Iodoral).

            One moldy peanut makes us rightfully suspicious of the whole bag, right?

            If you are sure allithiamine is safe and have no deals with manufacturers to cloud your priorities of safety and health then that’s that. Thank you!

            • Roland, it is safe for most people. How you will react is unknown. Each person reacts differently to different formulations and doses of thiamine and any other supplement. Allithiamine may work for you, it may not. You may need another formulation. Nothing is completely without risk or cost and no one supplement works for everyone. That is why it is imperative that one does the research for him/herself in advance and makes an educated decision about what to put into one’s body. That is why we wrote the book, not to sell thiamine, but to provide people with a framework for understanding their health and how thiamine works relative to health and disease. It is not a prescription or protocol, it is a framework for understanding. There is no one-size-fits-all. Just a very important framework from which to understand your health. What you do with that framework, how you apply what you have learned to your health remains up to you and your doctor, if you are working with one.

            • Many people have been helped greatly with “higher” doses of iodine through the work of doctors such as David Brownstein and George Flechas. Before slamming them, consider that many have overcome some tremendous health problems. Decide what side of the fence you’re going to be on, but respect those on the other side too.

            • You also might want to actually check out more of Elliot’s work. His along with Lonsdale and Marrs speaks for itself and he gives so many other options in his videos, articles, you name it, all for FREE. His guide for taking thiamine gives generic options and options for less potent versions (of which he makes no money) knowing full well that some of us (me included) can’t take TTFD. I hope Elliot is making truckloads of money and I wish everyone would buy “Thiamine Deficiency, Disautonomia, and High Calorie Malnutrion,” and an extra one to give to their doctor. People with the means to do so should donate whatever they can to this website because it’s THAT valuable. I think I’ve read every article on this website trying to understand a better way to heal and it has been nothing short of life changing for me and everyone else I’m guiding on this same journey. If I was a Billionaire then the people who have given this information away for free or donations would be set for life, but at least now with their guidance, I have a much better chance of achieving my goals and the future looks bright again and most of it if not all, is thanks to them.

  5. Exactly!! Thiamine is essential for making acetylcholine. Acetylcholinesterase destroys it. The idea of an inhibitor is to preserve the presence of acetylcholine where it is needed. The question that I always ask, is why is somebody not making acetylcholine? Thiamine deficiency will slow the citric acid cycle. The acetyl group derived from it has to combine with choline, also derived from diet, to make acetylcholine. You can see from this that thiamine deficiency is obviously a common cause of acetylcholine deficiency

    • Thank you for commenting. I would like to rely on nutrition rather than on the acetylcholinesterase inhibitor if possible. My doctor wants me to keep taking the drug for now, and I also want to take it so that I can exercise more successfully. But I will also continue with my vitamin regimen and with clean eating.

      The acetylcholinesterase inhibitor’s effects seem “too good to be true,” and no one claims they address the underlying condition, so I feel that if I relied on the drug alone, the underlying condition could worsen! So I’ll keep taking thiamine, etc.

  6. Dr. Lonsdale,

    I’m trying to connect your posts on mitochondrial function with some of the metformin criticism I’ve read on this site. I understand that mitochondria is so important that throwing a wrench into things is risky business… but I don’t really understand what the risks actually are. Medical journal articles on metformin and mitochondria are beyond my comprehension, and the more accessible discussions of metformin tend to praise it to the heavens with few reservations!

    I am interested because I took metformin for 15 years before quitting. After I quit taking it, I stopped experiencing the chronic muscle pain I’d been living with for months prior. I don’t know what that was all about or if it was even related, but now I wonder what the risks of going back on it would be.


    • Sarah, yes, the muscle pain was related to the metformin. It blocks important functions in the mitochondria involved with energy transport and wreaks havoc on the muscles, among other things. A word of caution about going back on metformin, folks tend to have very severe reactions if they have been on it before, stop and then return. Not sure why, perhaps because the mitochondria are already damaged and simply cannot take the additional hits. From personal experience, my mom, who had been on metformin for years, made changes to her diet and was able to be medication free for several years. She let her diet lapse, a GP prescribed metformin again, and she landed in the hospital within a few weeks. She became completely disorients, was unable to walk, her heart rate and BP were erratic. Essentially, everything went haywire. I have come across several patient stories like this. After the metformin was ceased and nutrients were back up, everything resolved and she has been medication free again for 2-3 years (except for an unrelated infection). If you are using it for diabetes, consider thiamine, we have articles on it related to diabetes. Also, consider eliminating sugars from your diet. The diet is most difficult thing to control. I know it was for my mom. Good luck.

      • Thank you, Dr. Marrs! I read about what a hard time your mom had with it; I am glad she is doing better. Thanks also for the caution about going back to it after a break; I was hoping it would take a while for side effects to ramp up again, but it sounds like that’s not how it works. The hospitalization must have been scary. I have had hypos on metformin before (not just falling BG, even though they say metformin won’t give you hypos), and that was bad enough.

        The metformin was for PCOS. My diet is restricted (grain-free, 80 grams of carb or less, no sugar for many years). I am hoping that I can replace metformin with exercise and inositol. I am taking magnesium and thiamine for syncope related to dysautonomia, and, so long as I faithfully take it every day, it is like a miracle cure. I haven’t lost any weight, water or otherwise, but we’ll see.

        Regarding diet… Have you ever read about taking tryptophan for a sweet tooth? It’s something the low-carb community sometimes recommends. I never had much of a sweet tooth, but I took a form of tryptophan for other reasons, and I did notice that even my mild preference for, e.g., a dash of stevia in sour yogurt just vanished. There’s an explanation involving serotonin; I don’t know if it’s medically sound, but people say it can help.

          • Sarah my wife suffer from PCOS, and thanks to Dr Londsale was able to figure out what happening. I agree whole heartily with Dr Marrs, going low carb and taking thiamine was life changing for my wife.

            The tryptophan issue comes up a lot for people these days as many people are on SSRIs these days, this up regulates that whole pathway and messes with Serotonin / Melatonin (sleeping and cortisol get worse) hacking it with tryptophan dosnt address the issue.

            Also i think this is why people crave sweeti things with PCOS as cortisol is high and insulin is high, and depletes and thiamine. Since thiamine is required for the gut, IBS kicks in and more of the Serotonin in the body is created in the Gut, then PCOS people get put onto SSRIs.

            • Thank you, Simon. I know I have high cortisol, and I think that’s part of why thiamine didn’t help until I added magnesium. I hope it helps me as much as it helped your wife. It is difficult to find good care for PCOS. I saw an expensive endocrinologist who concluded that I was already doing better than her other PCOS patients, so she didn’t have anything to offer. I feel that Dr. Lonsdale and Dr. Marrs set more ambitious goals for alleviating patients’ suffering as well as addressing what has gone wrong.

              • Sarah makes a comment that should be interesting to all who read this. She said that she had a high cortisol and believes that thiamin did not work because of this until she added magnesium.I want to point out once more that thiamin and magnesium work together because they are cofactors to several important enzymes that deal with energy metabolism. Therefore, the reason that she was not getting any benefit from thiamin was simply because she did not have magnesium. In fact, it is quite probable that the high cortisol was the result of the failure to take thiamin and magnesium together and it would have been interesting to know whether the cortisol came down into the normal range after the addition of magnesium.

                • The cortisol came down after quitting the pill (which I was also taking for PCOS, but never again).

                  Pyridostigmine bromide is helping me tremendously with dysautonomia, but I don’t want another bad experience like I had with metformin (I know the drugs are very different). I am currently hoping that the ability to exercise it’s granting me will both compensate for some side effects of the drug and also eventually allow me to quit taking it.

                  • Meanwhile, I will continue to take thiamine, a b-complex with folate, and magnesium to supplement a diet high in red meat and sources of choline–just in case this somehow helps me get more acetylcholine without relying on acetylcholinesterase inhibition.

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