Can We Heal Mitochondria? Functional Approaches to CFS Fatigue

by | May 20, 2025 | Home Page Display

functional mitochondria fatigue

Can We Heal Mitochondria? Functional Approaches to CFS Fatigue

Author: Rohan Smith | Functional Medicine Practitioner | Adelaide, SA

If you’re living with chronic fatigue syndrome (ME/CFS), you know it’s not just about being tired. It’s bone-deep exhaustion that sleep doesn’t fix, and for many, it feels like your body’s energy has simply vanished. One area gaining increasing attention is mitochondrial health—the tiny energy-producing structures inside your cells that may be struggling to function efficiently.

Can mitochondria be “healed”? Current evidence suggests that mitochondrial function in ME/CFS may be supported and, in some cases, partially improved, but not universally restored (1,2). Functional approaches focus on reducing biological stressors, correcting nutrient insufficiencies, and improving cellular efficiency rather than curing the condition.

Why Mitochondria Matter

Mitochondria are specialised structures within cells responsible for producing ATP (adenosine triphosphate), the primary energy currency of the body. Every muscle contraction, nerve signal, and metabolic process depends on adequate ATP availability (3).

Research in ME/CFS suggests abnormalities in mitochondrial energy production, redox balance, and recovery capacity, which may contribute to persistent fatigue and post-exertional malaise (4,5).

What Can Disrupt Mitochondrial Function in ME/CFS?

Mitochondrial efficiency may be impaired by several overlapping factors:

  • Oxidative stress caused by excess reactive oxygen species (6)
  • Nutrient insufficiencies affecting mitochondrial nutrient pathways (7)
  • Chronic immune activation and low-grade inflammation (8)
  • Toxin exposure and impaired clearance (9)
  • Compromised gut health reducing nutrient absorption and increasing inflammatory load (10)

Because these drivers often coexist, isolated interventions are rarely sufficient.

Nutrition to Support Cellular Energy

Mitochondrial ATP production relies on a steady supply of micronutrients acting as enzymatic cofactors.

  • Coenzyme Q10 (CoQ10): Supports electron transport and ATP synthesis (11)
  • Magnesium: Required for ATP activation and stability (12)
  • B vitamins: Essential for mitochondrial energy metabolism (13)
  • L-carnitine: Facilitates fatty acid transport into mitochondria (14)
  • Alpha-lipoic acid: Supports antioxidant recycling within mitochondria (15)

Dietary strategies form the foundation, with supplementation considered cautiously and individually, particularly in people with ME/CFS who may be supplement-sensitive.

Reducing Oxidative Stress and Inflammation

Mitochondrial dysfunction and inflammation can reinforce one another through oxidative damage and impaired cellular signalling (6,8).

  • Glutathione and its precursors
  • Vitamin C and vitamin E
  • Curcumin
  • Omega-3 fatty acids

Diet quality and inflammatory load play a significant role in modulating mitochondrial stress.

Gut, Liver, and Detox Capacity

If nutrient absorption is impaired or metabolic waste accumulates, mitochondrial efficiency may decline.

  • Probiotic and prebiotic support
  • Digestive enzyme support when clinically indicated
  • Foods supporting hepatic detoxification pathways
  • Adequate hydration and regular bowel function

Stress, Sleep, and Energy Regulation

Chronic stress signalling and dysregulated cortisol patterns may down-regulate mitochondrial activity over time (16).

  • Carefully selected adaptogenic herbs
  • Low-intensity movement within individual tolerance
  • Breathwork and nervous system regulation
  • Consistent sleep routines

Mitochondria-Focused Nutrients

Certain compounds are studied for their potential role in supporting mitochondrial function. These are not universally tolerated and should be approached cautiously.

  • PQQ
  • NAD⁺ precursors (such as NMN or NR)
  • D-ribose
  • Ubiquinol

In clinical practice, investigations such as mitochondrial function testing may help guide personalised decision-making rather than relying on generic protocols.

Is Meaningful Improvement Possible?

While mitochondria cannot always be fully “repaired,” functional approaches may support improved efficiency and resilience over time (1,2). For people with ME/CFS, progress is typically gradual and non-linear, with careful pacing essential to avoid symptom exacerbation.

Frequently Asked Questions

Can mitochondrial dysfunction alone explain ME/CFS fatigue?

No. While impaired mitochondrial energy production is an important contributor, ME/CFS is a complex, multisystem condition. Immune activation, oxidative stress, nervous system dysregulation, gut health, and hormonal signalling often interact with mitochondrial pathways, meaning fatigue rarely has a single cause.

Will mitochondrial supplements work for everyone with ME/CFS?

Not necessarily. People with ME/CFS often have heightened sensitivity to supplements, and responses vary widely. What supports mitochondrial function in one person may worsen symptoms in another. Personalised assessment and cautious, staged support are generally more effective than broad protocols.

Is it possible to fully restore mitochondrial function in ME/CFS?

Current evidence suggests that full restoration is not always possible. However, reducing biological stressors and supporting cellular efficiency may improve energy production and resilience over time for some individuals. Progress is typically gradual and requires careful pacing.

Key Takeaways

  • Mitochondria play a central role in energy production and fatigue in ME/CFS
  • Mitochondrial dysfunction is influenced by inflammation, oxidative stress, nutrition, and immune activation
  • No single supplement or intervention can “fix” mitochondrial fatigue
  • Support strategies work best when individualised and carefully paced
  • Improvement is often gradual and focused on resilience rather than cure

Exploring a More Individualised Path Forward

Living with ME/CFS requires more than generic advice or trial-and-error supplementation. Understanding how mitochondrial stress, inflammation, nutrition, and recovery capacity interact in your body can help guide more targeted and sustainable support.

A functional medicine approach focuses on identifying the biological factors placing the greatest strain on your energy systems, rather than chasing symptoms alone.

If you’d like to explore whether personalised assessment or testing may be helpful in your situation, you’re welcome to book a consultation to discuss your options.

Book a free 15min Discovery Call

References

  1. Missailidis D, et al. Redox imbalance and mitochondrial dysfunction in ME/CFS. J Transl Med. 2020.
  2. Naviaux RK, et al. Metabolic features of chronic fatigue syndrome. PNAS. 2016.
  3. Nicholls DG, Ferguson SJ. Bioenergetics. Academic Press. 2013.
  4. Myhill S, Booth NE, McLaren-Howard J. Chronic fatigue syndrome and mitochondrial dysfunction. Int J Clin Exp Med. 2009.
  5. Tomas C, et al. Cellular bioenergetics in ME/CFS. EBioMedicine. 2017.
  6. Maes M, et al. Oxidative stress and inflammation in CFS. Neuro Endocrinol Lett. 2011.
  7. Depeint F, et al. Mitochondrial function and micronutrients. J Clin Biochem Nutr. 2006.
  8. Morris G, Maes M. Immune-inflammatory pathways in ME/CFS. Mol Neurobiol. 2013.
  9. Genuis SJ. Toxicant exposure and mitochondrial dysfunction. J Environ Public Health. 2012.
  10. Galland L. The gut microbiome and the brain. Altern Med Rev. 2014.
  11. Hidaka T, et al. CoQ10 deficiency in chronic fatigue syndrome. Biochem Biophys Res Commun. 2008.
  12. de Baaij JHF, et al. Magnesium in cellular energy metabolism. Physiol Rev. 2015.
  13. Depeint F, et al. B vitamins and mitochondrial energy. Clin Chem Lab Med. 2006.
  14. Brass EP. Carnitine metabolism and mitochondrial function. J Nutr. 2000.
  15. Packer L, et al. Alpha-lipoic acid as a mitochondrial antioxidant. Free Radic Biol Med. 1995.
  16. McEwen BS. Stress and mitochondrial regulation. Ann N Y Acad Sci. 2017.