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Every one of the body’s trillions of cells is a busy, self-contained little world.
Just as the body contains life-sustaining organs, like the heart, brain, and liver, its cells are filled with microscopic organelles. These tiny specialized structures are like miniature organs, performing specific roles that keep the body humming.
While the nucleus has long been understood as the brain of the cell, holder of DNA, and director of gene expression, researchers now suspect another cellular component — the mitochondria — is running more of the show than we realized.
Unlike most organelles, mitochondria have their own DNA, their own membranes, and their own ancient history. These tiny structures originated about 1.5 billion years ago in ancient bacteria that were engulfed by archaeal cells, a process that gave rise to all complex life on Earth. Each human cell now contains hundreds to thousands of mitochondria, adding up to about 10 million billion throughout the body.
“The food you eat and the oxygen that you breathe converge somewhere in the body, and that somewhere is in your mitochondria.”
Mitochondria are often called the cell’s powerhouses, but Columbia University mitochondrial psychobiologist Martin Picard, PhD, prefers to describe them as transformers. “The food you eat and the oxygen that you breathe converge somewhere in the body, and that somewhere is in your mitochondria,” he explains.
Through a cascade of chemical reactions, mitochondria convert these raw materials into adenosine triphosphate (ATP), the energy currency that powers virtually every biological process. The cells with the highest energy demands — neurons and heart, muscle, and liver cells — pack in the most mitochondria.
And because mitochondria are effectively the engines that produce our energy, learning to support them may be one of the most powerful things we can do for our long-term health.
Mighty Multitaskers
In 2004, University of Iowa clinical professor Terry Wahls, MD, was reliant on a wheelchair. She was also losing her ability to sit upright. Diagnosed with multiple sclerosis several years earlier, she had declined steadily despite the best treatments conventional medicine had to offer.
A dedicated researcher, Wahls began experimenting on herself with supplements known to support mitochondrial function — a protocol she came to refer to as her “mitochondrial cocktail.” Years later, she came upon research from the Institute for Functional Medicine and added more supplements to her cocktail. Then she redesigned her paleo diet to emphasize mitochondria-supportive nutrients.
This was her aha moment. Within a few months, she was walking without assistance. Within a year, she was enjoying 18-mile bicycle rides.
Wahls’s exceptional recovery was the starting point for her development of a research program to study the dietary intervention that helped her. She wanted to understand whether focusing on mitochondria could help others with MS or related disorders.
Broader research now supports Wahls’s thesis: Our mitochondria provide a powerful point of intervention for a range of health conditions.
Our mitochondria provide a powerful point of intervention for a range of health conditions.
While energy production is their primary mission, mitochondria don’t stop there. They send signals that regulate cell activities, coordinate immune responses, discard damaged cells, and stimulate key building blocks for new cells. They help determine how clearly we think and how well we feel and move.
Mitochondria are “the ultimate multitaskers,” write Daria Mochly-Rosen, PhD, and Emanuel Rosen in The Life Machines: How Taking Care of Your Mitochondria Can Transform Your Health.
Mitochondria even power our ability to heal. When you cut your finger, skin cells around the edges of the wound need to come together for it to close. Mitochondria enable that process by traveling to the outer reaches of these cells and supplying them with energy to expand and close the gap.
Because mitochondria are involved in such a range of physiological processes, researchers have begun to explore the role they play in the development of age-related conditions like type 2 diabetes and dementia as well as autoimmune disorders and mental health challenges.
These are some other conditions in which mitochondria play a prominent role.
Cardiometabolic Health
Because mitochondria are the hubs of energy metabolism in our cells, they play a central role in metabolic disorders, including prediabetes and type 2 diabetes.
To illustrate how, functional-medicine physician Robert Rountree, MD, points to what he calls the “energy paradox” — why someone with metabolic syndrome can eat thousands of calories a day yet feel a lack of energy.
“The answer lies in the mitochondria,” he says. “If you do a biopsy of the muscles of these people, their mitochondria are smaller, and the little factories within them that make ATP aren’t there.”
When mitochondria are working well, they’re efficient at converting food into ATP, drawing on both glucose and fat as fuel sources, depending on what the body needs.
But when the mitochrondria are struggling, a lot can go wrong. Poorly functioning mitochondria can get stuck in glucose-burning mode and lose their ability to burn fat. Unburned fat accumulates in the liver and muscle tissue. And fatty liver can eventually lead to type 2 diabetes.
When fat accrues inside cells, mitochondria become overwhelmed, producing less ATP and more free radicals. The free radicals, in turn, make the mitochondria even less efficient.
“The whole process just builds up and builds up,” Rountree says.
And because heart cells are up to 40 percent mitochondria by volume, the overall health of the cardiovascular system is particularly vulnerable to the effects of this harmful spiral.
Aging
Perhaps unsurprisingly, mitochondrial function also shapes how we age — which is about more than wear and tear.
In parts of the body that require a lot of energy, like the brain and heart, the mitochondria are essentially high-output furnaces, burning hot around the clock. This means they’re constantly generating free radicals as a byproduct. And their own DNA are especially vulnerable to damage from these reactive molecules.
That damage multiplies over time. Injured mitochondrial DNA affects the enzymes the body uses for energy production, leading to less ATP and more free radicals that cause further harm.
Meanwhile, the body’s repair mechanisms, which normally patch up these dings, begin to lose their edge. “As we age, we lose mitochondria,” says Rountree. “They just start going away.”
Part of the reason for this loss, he explains, is that the body’s ongoing cycle of breaking down damaged mitochondria and generating new ones begins to wind down.
“Our mitochondria are being recycled all the time,” Rountree says. “As we age, that process gets less and less efficient.”
A 2016 review in Molecular Cell found that declining mitochondrial health may drive some of the most significant consequences of aging, including loss of muscle mass, chronic inflammation, and a weakened capacity for tissue repair.
The good news, says Rountree, is that these issues aren’t inevitable. Deliberate lifestyle choices can actively support mitochondrial renewal well into later life. (More on that shortly.)
Brain Health
The brain’s mitochondria are almost always running near full capacity, monitoring heart rate, temperature, digestion, and other internal signals. One report estimates that the brain uses about 16 times more energy than skeletal muscle at rest — about as much energy as leg muscles use running a marathon.
So it makes sense that anything placing a high energy demand on the body and brain — such as infections, stress, and hormonal transitions, like puberty — is often accompanied by mental fogginess.
“How we feel depends on energy flowing through the brain,” Picard says. “When energy can’t flow properly or coherently, that changes our experience.”
In this framework, depression, anxiety, and bipolar disorder can all be understood as disruptions in the brain’s energy flow rather than fixed biochemical deficits.
Still, it’s not just the brain’s mitochondria that affect cognitive health. Mitochondria can migrate beyond the cells where they originate, and studies suggest the condition of mitochondria in skeletal muscles may be a predictor of cognitive impairment. Researchers at the National Institute on Aging found, in a study of 469 people published in 2023, that lower mitochondrial function in the participants’ muscles was associated with an increased risk of mild cognitive impairment or dementia.
Conversely, participants with higher muscle mitochondrial function were less likely to develop cognitive impairment, suggesting that improving mitochondrial function in muscle may be beneficial for brain health. Yet another good argument for strength training.
Threats to Mitochondria
The early signs of mitochondrial dysfunction are easy to mistake for normal aging or poor fitness. Fatigue is the most common symptom, though it’s often accompanied by low exercise tolerance, brain fog, memory problems, and a general sense of diminished vitality. Insulin resistance and elevated blood sugar are other signals that mitochondrial function may be faltering. (About one in five adults deals with fatigue, and one in 10 experiences chronic exhaustion. See “8 Reasons You Might Be Tired — and How to Recharge” for more.)
Symptoms tend to be most pronounced in the systems with the highest energy demands. Mitochondrial dysfunction in the brain can be signaled by cognitive fog or mood disturbances. In the heart or skeletal muscle, it often shows up as exercise intolerance and fatigue.
Still, there are things you can do to intervene and protect your mitochondrial health. Wahls offers a simple two-part directive: “One is stop poisoning your mitochondria,” she says, “and two is start nourishing your mitochondria.”
Mitochondrial poisons are rampant, with free radicals being the most prevalent. Counterintuitively, mitochondria generate these harmful molecules as a byproduct of energy production, and they can damage mitochondrial DNA and enzymes when they accumulate unchecked. This makes mitochondria progressively less efficient.
Environmental toxins compound this damage. These include heavy metals like mercury, arsenic, and lead, as well as pesticides, microplastics, and air pollutants. “We live in such a chemical-rich environment, and many of these compounds are toxic to our mitochondria,” says Wahls.
Caloric overconsumption also taxes mitochondrial health. “If you overload the mitochondria with too much sugar and too much fat, especially in combination, they get overwhelmed,” Picard explains. “It’s called metabolic oversupply.”
Some antibiotics, certain antidepressants, and some statins have also been shown to interfere with mitochondrial function. Poor sleep and early-life adversity can take a toll as well.
Finally, chronic psychological stress has an outsize impact on mitochondria. Picard’s research points to a two-way street between mental states and mitochondrial biology: Just as damaged mitochondria can drag down mood and cognition, chronic psychological stress can reshape the energy of the body at a cellular level.
In a study from Picard’s lab, human cells exposed to cortisol-like stress signals increased their energy expenditure to roughly 60 percent above baseline, taking energy from processes needed for cellular maintenance and repair. This could be one way that chronic stress literally wears the body down over time.
In other research, Picard found that simply telling study participants they were about to be judged on a public-speaking task was enough to raise levels of the protein marker GDF15 in their blood.
This mitochondrial stress signal is an indicator of what Picard calls energy resistance, a state in which electrons flow with too much resistance through metabolism.
“State of mind can really change the energetics of the body,” he says.
Separate research has found elevated GDF15 levels in people who are lonely or socially isolated. Over time, these energetic disruptions may eventually lay the groundwork for chronic disease.
How to Defend Your Vitality
The same lifestyle factors that support overall health — eating well, moving regularly, managing stress, sleeping enough — turn out to be exactly what your mitochondria need. The following levers are among the most meaningful for mitochondrial support.
Nutrition
Mitochondria depend on a steady supply of nutrients to run their energy-producing machinery. B vitamins are essential cofactors, along with the minerals magnesium and zinc, says integrative-medicine physician Kurt Woeller, DO.
The inner membranes of mitochondria are made partly of fat. That means they require a good supply of healthy lipids: cholesterol, omega-3s, omega-6s, and phospholipids. Wahls notes that phospholipids are most easily obtained from animal foods, so if you’re vegan, you’ll have to seek them out from other sources.
Overall diet matters too. Eating a diverse diet with plenty of vegetables supports the vitamins and minerals mitochondria need. To avoid metabolic oversupply, steer mostly clear of calorically dense combinations of fat and sugar.
Intermittent fasting can also help. It appears to trigger mitophagy — the body’s process of purging damaged mitochondria — while stimulating the growth of healthier mitochondria. “When you’re hungry, the body weeds the garden of bad mitochondria, and then the good ones can actually grow and flourish,” Picard explains. (For more, see “Everything You Need to Know About Intermittent Fasting.”)
Exercise
If there is a single most powerful intervention for mitochondrial health, it may be movement. Anything that makes you breathe harder — cardio and endurance work, including brisk walking — drives mitochondria to consume more oxygen. This signals your body to produce more mitochondria.
“If you breathe harder, energy is flowing through your system. And when that happens, the system says, ‘The next time this happens I need to be ready,’” Picard says. If you were to go from being completely sedentary to eventually training for a marathon, “you can double the number of mitochondria in your muscles.”
Cardio exercise also stimulates autophagy — the larger cellular process by which damaged cell structures are recycled into new components — and prompts cells to bolster their antioxidant defenses.
Resistance training is also key. “If you’re really interested in your mitochondria, you need to build muscle mass,” says Rountree. Current research supports combining cardio and strength training, as each contributes to mitochondrial health in complementary ways.
Mindset
Picard believes the things that energize us, such as a sense of purpose and meaningful human connection, may be acting on mitochondria at a deeper level.
Evidence for this view is building.
A study from one of Picard’s colleagues, Caroline Trumpff, PhD, found that people who reported greater well-being, social engagement, and purpose in life had greater mitochondrial energy capacity in the prefrontal cortex.
Meanwhile, those reporting more negative experiences, loneliness, and feelings of stress had less capacity.
While none of us can eliminate stress completely, cultivating positive, relaxed states does appear to be helpful for our mitochondria.
A 2024 paper proposes that contemplative practices, like meditation, yoga, and prayer, can benefit the body in concrete ways, in part by inducing a state of genuine rest through safety signaling. When the body feels safe and secure, it enables mitochondria to redirect energy away from the demands of the stress response and back toward cellular repair and maintenance.
Supplements
Both Picard and Rountree view supplements as one spoke in the wheel of mitochondrial health. “There’s not any one substance that’s going to do the trick,” Rountree says.
That said, there are compounds that can be useful for mitochondrial support. Picard points to NAD+, a critical coenzyme for mitochondrial energy flow that declines with age.
Rountree notes that creatine has shown some benefits for brain function and post-COVID fatigue. He also sees promise in berberine, a plant compound used in Traditional Chinese Medicine. Berberine may stimulate mitochondrial biogenesis by activating the same cellular mechanism that’s triggered by exercise and fasting.
CoQ10, another potent antioxidant, may be valuable as part of a broader protocol, particularly for those with mitochondrial dysfunction, Rountree says.
Still, for most of us, the most meaningful support comes from honoring the fundamentals — diet, movement, sleep, and emotional health. Our mitochondria, it turns out, are listening. They respond to how we live.
Mitochondrial Testing
A handful of at-home tests now claim to measure mitochondrial health, but experts are divided about their utility.
Functional-medicine physician Robert Rountree, MD, considers concrete measures such as VO₂ max, hemoglobin A1C, fasting glucose, and liver panels to be the most reliable readouts of metabolic function.
Integrative-medicine physician Kurt Woeller, DO, recommends the Organic Acids Test (OAT). This is a urine-based screen for mitochondrial imbalances and related nutrient deficiencies.
And functional-medicine physician Terry Wahls, MD, points to a simple, free option: the Medical Symptoms Questionnaire (widely available online). A score under 20, she says, generally suggests your mitochondria are functioning well; over 20 is a flag worth heeding.
Meanwhile, Martin Picard, PhD, a mitochondrial psychobiologist at Columbia University, is developing a research platform around what he calls “mitoception”: the body’s capacity to perceive its own mitochondrial energy flow.
“We hope this platform will eventually help people tune in to their energetic state,” he says. For now, he believes we can get useful insight simply by turning our attention inward to ask, How do I feel? How is my energy?
“Our ability to feel, tune in — that is the best instrument we have,” he says.
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