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COVID Notes: “I Don’t See A Role For Mitochondria.” Say What?

Published on April 12, 2021

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covid notes mitochondria immune function

A persistent notion in medicine is that the only time mitochondria precipitate, or in any way influence illness, is when mDNA mutations are involved and/or with frank starvation. Absent those two events, the magical mitochondria will keep chugging along and there is no need to consider their impact on health or disease. This belief emanates partly from another all-too-persistent notion that holds tightly to a compartmentalized model of organismal function, suggesting that each bodily system and thus each disease process is unique and distinctly separate from everything else, and partly from the way most folks are taught about mitochondria – by rote memorization of the Krebs cycle. As a result and except in specific circumstances, most physicians and many researchers see no role for mitochondria in health or disease.

This is true with COVID as well. Even though COVID presents disparately across patient populations, is clearly not limited by body compartment or system, and not only does not fit within any diagnostic model to date but shatters everything we think we know about illness, folks are reticent, nay adamant, that mitochondria are not involved. COVID is not a mitochondrial illness, they proclaim. To that end, on a somewhat regular basis, I see posts, threads, and comments about just how unimportant mitochondria are to COVID and really, to health in general.

Stressed Mitochondria, Inflammation, and COVID

Some months ago, a gentleman argued that the chronic inflammation caused by COVID was related solely to altered immune function similar to that seen in conditions like rheumatoid arthritis or lupus. He went on to say that he did not see any role for mitochondria in this. Similarly, another gentleman was equally adamant that there was no known relationship between “mitochondrial health impacting which immune response or pathway will be activated.” He argued further that my suggestion of stressed mitochondria triggering the inflammatory responses seen in COVID-related blood pressure drops and cytokine storms was not possible per the tenets of modern immunology. It was foolhardy for me to consider otherwise.

Beyond the obvious faceplant response – ‘as if the immune system could function without the help of the mitochondria; as if anything could function without the mitochondria’ – there is an ample amount of research linking mitochondrial function to immune function predating COVID and a burgeoning body of research linking mitochondrial response to COVID severity. Indeed, some of the more recent research suggests that not only does SARS- COV2, the viral protein associated with COVID directly influence mitochondrial function like many other viruses do, but also that it is only the host variables e.g. mitochondrial fitness that determine how far the virus is allowed to progress. Mitochondria, it appears, are the determining factor of illness severity, something I have been saying since the beginning of this pandemic.

When this particular series of ‘COVID does not involve the mitochondria’ comments came up, I was speaking about the hijacking of the mTOR pathway by other viruses and speculating as to whether COVID might do the same. The mTOR pathway includes a set of enzymes that regulate cell and mitochondrial metabolism via multiple mechanisms. Though mTOR are not mitochondrial proteins, as they are located in the cytosol adjacent to another set of organelles called lysosomes, they provide critical signaling to mitochondria involving energy metabolism and stress response. In fact, mTOR coordinate mitochondrial energy consumption and production. They initiate these nutrient signals by binding or unbinding themselves to the lysosomes. Among those signals that mTOR respond to is protein or amino acid status. Low protein effectively inhibits mTOR enzymes. Absent outright starvation, which is entirely possible in critical illness, protein metabolism is dependent upon mitochondrial function. Specifically, protein catabolism and synthesis both require energy or ATP, which in turn requires an array of micronutrient co-factors to power mitochondrial enzymes, the machinery involved in these processes.

Returning to the claim that the COVID cytokine response was akin to the autoimmune diseases like arthritis or lupus, that claim is absolutely correct. The response is akin to one of an autoimmune disease process, but what most fail to recognize is that autoimmune disease process is itself tied to the mitochondria, through multiple channels, including mTOR. Since these conversations arose from a post on viral hijacking of mTOR and the inflammatory patterns observed with autoimmunity, let us dig into those relationships.

Th-17 Cells, mTOR and the Mitochondria

Common to both the severe and long COVID and autoimmune illness, are hyperactive pro-inflammatory Th17 cells with underactive anti-inflammatory Treg cells. Th17 modulation is tied to mitochondrial fitness. The Th17 response is thiamine dependent. Thiamine is the rate limiting co-factor to key enzymes involved in mitochondrial energy production, including those at the entry points for the glucose, fatty acid, and amino acid pathways and other enzymes within the TCA/Krebs cycle. Thiamine deficiency derails mitochondrial energy production, shifting it from oxidative phosphorylation and towards aerobic and eventually, anaerobic glycolysis. Even aerobic glycolysis, however, is thiamine dependent. These shifts in energy production are mitochondrial danger signals to the immune cells, including Th17 proinflammatory response. The mTOR proteins, are also involved. When oxidative phosphorylation, glutamine metabolism, and fatty acid synthesis, all which are thiamine dependent, are lagging and energy wanes (e.g. with insufficient thiamine or other mitochondrial nutrients), mTORs energy metabolism becomes anaerobic and pro-inflammatory – e.g. Th17s upregulate and the anti-inflammatory Treg cells downregulate.

Renowned mitochondrial researcher Robert Naviaux would tell us that in both autoimmunity, and in COVID, particularly Long COVID, the mitochondria are stuck in battleship mode; that they lack the energy not only to complete the tasks at hand, but to create more energy. Dr. Lonsdale would tell us that this is because the mitochondria lack the sufficient nutrients to convert food into energy, especially thiamine. From our book, notice how many times thiamine, vitamin B1, is required. Notice also, how many other micronutrients are required to convert food substrates, glucose, proteins, and fatty acids into ATP.

Now consider the high calorie, low nutrient composition of the modern American diet, the metabolic dysfunction associated with the severity and chronicity of COVID, and the range of inflammatory disorders afflicting many of the patients who develop severe and/or long COVID. These are connections that must be recognized.

We know that absent sufficient mitochondrial nutrients, energy wanes. When energy wanes, inflammatory cascades remain unchecked; among them, hyperactive pro-inflammatory Th17 and underactive anti-inflammatory Treg cells. We have to consider also that although pharmaceutical interventions may abrogate that inflammation superficially and temporarily, they do nothing resolve the underlying issue, which is micronutrient deficiency. Since most, if not all, medications damage mitochondria by one mechanism or another, their use, while necessary in some instances, ultimately imperil mitochondrial capacity and exacerbate any underlying energy deficiency as well. So, when we look at folks most at risk for the more severe cases of COVID and/or those who develop symptoms consistent with Long COVID, it is important address the inflammatory response caused by the lack of sufficient energy.

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Poor Nutrition Stress: The Enemy of Health

by Derrick Lonsdale MD, FACN, CNS

Published on May 6, 2014

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In previous posts, I have indicated that stress can initiate or exacerbate disease and medication or vaccine adverse reactions. Read that statement, you might think I am attributing the onset of serious disease and adverse reactions to a psychosocial cause. That is not the case. Stress comes in a myriad of forms, some external, some internal, and although much of what we call stress relates to psychosocial responses to perceived threats, I think stress encapsulates so much more. At its most fundamental level, stress represents a physical state where the body is performing less than optimally. Let me explain.

What is Stress?

I define the word “stress” as a physical or mental force that is acting upon you. An example of mental or psychosocial stress might be an insult from a person, meaning that the stress comes from a source outside the body. On the other hand, it might be the realization that a deadline has to be met, a mental source from within. Any form of injury is an obvious source of physical stress. Physical action such as shoveling snow is another form of stress, demanding energy consumption imposed by the individual who wishes to get rid of the snow. Being infected with a virus or by bacteria is a form of stress that demands a defensive reaction. In each of these instances, the body reacts to the inflicting stressor. Sometimes, when the resources are available, it reacts efficiently. Other times, when the resources are not available or when additional factors intercede, the body’s response to the stress is ill-adapted.

Your Body is Your Fortress, Your Immune System the Soldiers

Perhaps an analogy might help to provide an explanation for the remarks that follow. I imagine the body as being like an old fashioned fortress. The people living within it go into action when the fortress is attacked by an enemy from outside. It would be of little use if the defense soldiers went to the eastern battlements if the attack came from the west and so there had to be a central figure that would coordinate the defensive reaction. The nature of the attack would be spotted by a guard on duty and the central figure informed by messenger.

The body represents the fortress and the lower part of the brain represents the central figure that coordinates the defense. The cells in the blood known as white cells can be thought of as soldiers, armed with the necessary weapons to meet the nature of the enemy. Suppose, for example, a person’s finger is stuck by a splinter carrying a disease bearing germ. The pain, felt in the brain, recognizes its source and interprets it as a signal that an attack has occurred. White cells in the area can be regarded as the “militia under local command” and a “beachhead” is formed to wall off the attack. The white cells sacrifice themselves and as they die, they form what we call pus. If the beachhead is broken and the germs manage to get into the bloodstream, it is then called septicemia and the brain/body goes into a full defensive reaction where high fever is the most obvious result. Such an illness is an attack/defense battle.

The symptoms that develop from such an infection represent the evidence for this defense, feeling ill, pain and developing a fever are excellent examples. Micro-organisms are most efficient at 37° C, the normal body temperature. The rise in body temperature, initiated by the brain, makes the microorganisms less efficient and may kill some of them. One therefore has to question the time honored method of reducing the fever, during illness, as being an example of good treatment. While reducing fever improves the symptoms caused by the infection, it also reduces the efficiency of the immune battle raging within.

The outcome against the stressor is death or recovery; although it is possible sometimes to end up in a kind of stalemate, represented by prolonged symptoms of ill health. Chronic illness may be viewed as the immune system’s inability to eradicate fully the stressor.

Poor Nutrition and Stress

As I have emphasized in previous posts, the autonomic (automatic) nervous and endocrine systems are used to carry the messages between the body and the brain that enable the defense to be coordinated. This demands a colossal amount of cellular energy, no matter the nature of the stress. That energy to fight stress comes from oxidation of the fuel that is provided from nutrition. Of course, the greater the stress the greater the energy demand, but in the end the equation is quite simple. If the energy required to meet the stress is greater than the energy that is supplied, there must be a variable degree of collapse within the defensive system. That collapse presents as intractable symptoms, where the body is unable provide the energy needed to sustain health. This is the secret of the autonomic dysfunction in the vitamin B1 deficiency disease, beriberi. It is also the secret behind the initiation of POTS because both conditions are examples of defective oxidation. You can read more details regarding thiamine deficiency, beriberi, POTS and other health issues from previous posts on this website

High Energy Demands Equal High Nutritional Demands

Nutrient density of diet might appear to be perfectly adequate for a given individual, but inadequate to meet the self-initiated energy demands of a superior brain/body combination in a highly active individual such as an actively engaged student or athlete. Our genetic characteristics, the quality of nutrition and the nature of life stresses each represent a factor that all combine together to give us a profile for understanding health and its potential breakdown.

Epigenetics and Mitochondria: The Stress of Our Parents

Epigenetics, the science of how our genes are influenced by diet and lifestyle, is relatively new. Epigenetics considers the possibility that genes can be activated and deactivated by nutrition and lifestyle. Stress can come in many forms, from psychosocial trauma, poor nutrition, environmental and medical toxin exposures, to infections. Stress impacts how our genes behave. Even though one may inherit a hard-coded genetic mutation from a parent, that mutation may not be activated unless exposed to a particular type of stress. Similarly, an individual who may have no obvious illness-causing genetic abnormalities but stress, in the form of nutritional depletion, exposures or trauma, can turn on or turn off a set of genes that induce illness. What is remarkable about epigenetics is the transgenerational nature of the stressors. The memories of stressors affecting our parents and even our grandparents can affect our health by activating or deactivating gene programs.

We also have to consider the state of our mitochondria, the “engines” in each of our cells that produce the energy for cellular function (to learn more about mitochondria and health, see previous posts on this website). Mitochondria have their own genes that are inherited only from the mother. Damage to the DNA that makes up these genes sometimes explains the similarity of symptoms that affect a given mother and any or all of her children. For example, although this damage may be inherited, we also have scientific evidence that thiamine deficiency, known to be the result of poor diet, can damage mitochondria. A bad gene might be the solitary cause of a given disease, but even where this is known as the cause, the symptoms of the disease are sometimes delayed for many years, suggesting that other variables must play a part. A minor change in cellular genetic DNA might be alright to meet the demands of normal living, but impose a risk factor that could be impacted by prolonged stress or poor nutrition, and disease emerges.

Nutrition is the Only Factor that We can Control

The imposition of stress on any given individual is variable, most of which is accidental and out of our control. Therefore, if we represent these three factors, genetics, stress and nutrition as three interlocking circles, all of which overlap at the center of such a figure, there is actually only one circle over which we have control and that is nutrition. We now know from the science of epigenetics that nutritional inadequacy can affect our genes. By examining the mechanism by which we defend ourselves against stress, we can also see the effect of poor nutrition.

Poor Nutrition Equals a Poor Stress Response

Using these three variables, perhaps we can begin to understand several unanswered questions. Why does a vaccination negatively affect a relatively small percentage of the total population vaccinated? Or why do some medications negatively impact only some individuals? It might be because of a genetic risk factor or because of a collapse of the coordinated stress response related to quality of nutrition or a combination of both. Why does a vaccination tend to “pick off” the higher quality students and athletes? Again, the same kind of answer; high quality machinery demands high quality fuel. Since the limbic system of the brain has a high energy demand and represents the computer that coordinates a stress response we can understand the appearance of beriberi or POTS and cerebellar ataxia, all examples of a deviant response to stress. Nutrition, therefore, should not be looked at as supplement to good health, but as the foundation of health. When disease or medication and vaccine reactions emerge, efforts to identify and then restore nutritional deficiencies must be the first line of immune system health. Without critical nutrients, the body simply cannot mount a successful stress response and the battlefield will expand and eventually fall.