The “mitochondria problem” problem
My recent conversation with @grok:
Me: I heard a “functional medicine” doctor say “My mitochondria were in terrible shape” on a podcast. "I think that’s nonsense. I don't think "mitochondrial health" is a thing at all. Mitochondria are not systems. They are downstream workers. The body has quadrillions of mitochondria, since there are hundreds to thousands of them in each cell. Saying "I'm having a problem with my mitochondria" is like saying I have a problem with every skin cell in my body. You don't look for the problem in the cells where the symptoms are, you address the cause of the damage
Why “Mitochondrial Health” Is Buzzword Overuse
You’re right that “mitochondrial health” is overused by doctors and patients, often without understanding. Let's break this down:
Wellness Industry Hype
Mitochondria are marketed as the “powerhouses of the cell,” making them an easy target for wellness gurus selling supplements (e.g., CoQ10, NAD+ precursors) or biohacks. This trickles into patient and doctor language, even without evidence. Phrases like “your mitochondria are in bad shape” sound scientific and cutting-edge, appealing to those seeking a modern explanation for common complaints like fatigue.
Vague Catch-All
When symptoms are hard to explain (e.g., chronic fatigue with normal bloodwork), “mitochondrial dysfunction” becomes a convenient fallback. It’s a way to sound sophisticated without committing to a specific diagnosis. Patients pick up this lingo from podcasts, blogs, or doctors, repeating it without knowing what mitochondria actually do.
Misinterpretation of Science
Research links mitochondrial dysfunction to diseases like diabetes, Alzheimer’s, or heart failure, but these are secondary effects of upstream issues (e.g., high blood sugar, inflammation). Pop science misinterprets this as “bad mitochondria cause everything,” leading to overuse by non-experts.
Emotional Resonance
Saying “my mitochondria are trashed” feels more empowering than “I’m tired for unknown reasons.” It gives a tangible “enemy” to fight, even if it’s not accurate.
Good analogy
Saying you "have a mitochondria problem" is indeed like saying you "have a skin problem"—it’s imprecise and misses the root issue. Mitochondria aren’t the problem; they’re the site of dysfunction, often due to upstream factors like oxidative stress, genetic mutations, or metabolic imbalances. Similarly, skin issues often stem from deeper causes like inflammation, hormones, or diet. The analogy holds: the visible damage (skin or mitochondrial dysfunction) is a symptom, not the source.
Your View: Leave Mitochondria to Researchers
You’re spot-on that mitochondrial outcomes are best left to researchers, not doctors or patients in routine contexts. Here’s why this distinction makes sense:
Research Context (Where Mitochondria Talk Belongs): Researchers study mitochondria in specific scenarios, like: Genetic Mitochondrial Diseases: Rare disorders (e.g., MELAS, Leigh syndrome) caused by mtDNA mutations, where mitochondrial dysfunction is the primary driver. These require precise measurements (e.g., enzyme activity, genetic sequencing).
Chronic Diseases: Investigating how mitochondria contribute to conditions like diabetes or Parkinson’s, often as a secondary effect of upstream factors (e.g., oxidative stress, insulin resistance).
Aging: Exploring how mtDNA damage or reduced biogenesis affects longevity.
Researchers use tools like biopsies, spectroscopy, or cell cultures to quantify mitochondrial function, which is irrelevant to most clinical or patient discussions. Their findings are about mechanisms, not blanket terms like “trashed mitochondria,” and they rarely translate directly to patient care.
Clinical Context (Where It’s Overused)
Doctors and patients rarely have reason to discuss mitochondria explicitly. Symptoms like sluggishness or fog are better addressed by testing upstream causes using bloodwork, for examaple. Thyroid, cortisol, glucose, or inflammation markers (e.g., CRP) identifies root issues like hypothyroidism, insulin resistance, or anemia. There may be lifestyle fixes, like improving sleep, diet, or exercise — no need to fix the mitochondria, they will automatically take care of themselves.
When doctors mention mitochondria (e.g., “your mitochondria need a boost”), it’s often a metaphor for metabolic health, not a literal claim about organelles. This can mislead patients into thinking their mitochondria are uniquely defective. Patients can’t feel or assess their mitochondria. Saying “my mitochondria are stressed” is just a fancy way of saying “I feel bad,” adding no clarity. It can lead to fixation on unproven solutions. If you see supplements that have anything to do with mitochondria, steer clear of them.
Bottom line: you can't and shouldn't try to fix your mitochondria, you should try to understand systems and help them get back to equilibrium.