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Mitochondrial Health 101: Caring for Your Cells’ Powerhouses

Written by Dr. Michael Ruscio, DC on June 24, 2025

Written by Dr. Michael Ruscio, DC on June 24, 2025 — Reviewed by Kellie Blake

• What Are Mitochondria?|
• Mitochondrial Problems|
• Diet|
• Exercise|
• Red Light Therapy|
• Hyperbaric Oxygen|
• Supplements|
• The Cell Danger Response|

On my blog and podcast, I often talk about eating better, exercising smarter, and managing stress. But have you ever wondered how these habits impact your health at the cellular level?

That’s where mitochondria (singular mitochondrion) come in. These microscopic structures are best known for producing energy, but emerging research suggests they also influence everything from metabolism and immunity to overall wellbeing.

In recent years, mitochondrial health has become a major focus in functional medicine. But what exactly are mitochondria, and why are they so crucial to how you feel and function day to day?

In this Mitochondrial Health 101, we’ll dive into the role of mitochondria, how they can falter, and the warning signs something may be off. We’ll also touch on the cell danger response, which may explain why a few people stay trapped in fatigue, brain fog, or chronic illness.

Whether you’re looking to reclaim your energy, support healthy aging, or get to the root of persistent symptoms, I’ll help you understand mitochondria and take practical steps to support your cellular health.

What Are Mitochondria? The Spark of Life

Mitochondria are tiny, adaptable organelles found in nearly every cell in your body. Often called the “powerhouses” of the cell, their most famous job is producing ATP (adenosine triphosphate)—the energy your body uses to move, think, repair, and survive.

Energy for Everything

Here’s the process in simple terms: When you eat food—carbohydrates, fats, or proteins—your body breaks it down into molecules that release electrons.

Electrons are tiny, negatively charged particles that carry energy. These electrons travel through the electron transport chain (ETC) inside your mitochondria—the ETC is like a biochemical conveyor belt.

As electrons move along the ETC, they help build up stored energy across a membrane inside the mitochondria.

That energy is released by a protein machine called ATP synthase, which spins like a miniature turbine to generate ATP, the fuel your cells run on 1.

More Than Fuel Factories

But mitochondria don’t just produce the energy currency for every cell. They also regulate calcium, produce heat, and generate reactive oxygen species (ROS), including highly reactive free radicals 1. When kept in balance, ROS production helps your immune system respond to stress or infection.

What makes mitochondria so remarkable is their constant adaptability. Through a process called mitochondrial dynamics, they change shape, split, or merge to meet your body’s needs. This flexibility is essential for cellular energy production, growth, movement, and even healthy aging 1.

To keep things running smoothly, your cells rely on mitophagy, a cleanup process that removes worn out or damaged mitochondria before they cause harm—it’s like taking out the cellular trash 1. This is one way your body maintains cellular function and homeostasis, or balance.

But when mitochondria malfunction, the effects can ripple through your body, particularly in high-energy organs like the brain, heart, muscles, and kidneys 2.

Mitochondrial Health Problems

Mitochondrial issues generally fall into two main categories:

• Lifelong mitochondrial diseases, caused by rare, inherited genetic mutations
• Vague, more general mitochondrial dysfunction, often linked to lifestyle factors

Genetic Mitochondrial Conditions

Inherited mutations in mitochondrial DNA (mtDNA), although rare, can have serious effects on systems that rely heavily on energy, like muscles and the brain. Symptoms typically cluster into these two main patterns:

Mitochondrial myopathy, affecting muscles and causing 2:

• Muscle fatigue
• Weakness
• Extreme fatigue linked to physical activity

Mitochondrial encephalomyopathy, involving neurological symptoms such as 2:

• Vision loss (due to optic nerve or retinal damage)
• Migraines and seizures
• Hearing loss (due to mitochondrial damage in the inner ear or nerve)
• Balance and coordination problems (ataxia)

Examples of genetic mitochondrial diseases include Leigh Syndrome, MELAS, and MERRF. Diagnosing these conditions is complex and may involve genetic testing, brain imaging (CT or MRI), heart tests (EKG), and muscle biopsies 2.

After a diagnosis of a mitochondrial condition, regular medical follow-up is essential to manage complications and monitor disease progression.

Some of the lifestyle strategies I’ll describe later in this article may help ease mitochondrial disease symptoms. But inherited conditions are generally beyond the scope of this guide and are not currently curable, though their symptoms may be managed.

Mitochondrial Dysfunction

This broader, less clearly defined form of mitochondrial impairment is what we’ll focus on for the rest of this article. It’s often linked to the aging process but is also strongly related to lifestyle factors that place stress on the mitochondria. For example:

• A poor diet lacking essential nutrients can deprive mitochondria of the materials they need for ATP production 3.
• Chronic stress—particularly physiological stress caused by a cycle of chronic inflammation and oxidation—can damage mitochondria and impair their function 4.
• Viral infections can hijack mitochondrial resources for the virus’s own benefit 5.

Having dysfunctional mitochondria isn’t an official diagnosis and is usually a diverse pattern of non-specific symptoms. Functional medicine practitioners may identify non-genetic mitochondrial dysfunction based on symptoms such as:

• Persistent fatigue or low energy
• Brain fog and trouble focusing
• Premature or excessive skin wrinkles
• Poor eyesight
• Slow wound healing
• Unexplained pain

Over time, low-level mitochondrial disruption may contribute to chronic conditions like type 2 diabetes, neurodegeneration, or even cancer 1.

Testing for Mitochondrial Dysfunction

Practitioners may try to confirm mitochondrial dysfunction through specialized tests. These may include 2:

• Organic acids testing
• Heavy metals and pesticides screens (on the basis that environmental toxins are a potential cause of mitochondrial dysfunction)
• Specialized mitochondrial function panels (e.g. Religen Inc.’s MitoSwab)

Personally, I find it’s usually not necessary to start with expensive testing. Moving straight in with simple lifestyle changes often significantly improves symptoms related to mitochondrial dysfunction. If a client’s progress stalls, then we’ll consider testing.

Unlike inherited mitochondrial diseases, lifestyle-driven mitochondrial dysfunction is often reversible. With the right support, many people experience noticeable improvements in energy, focus, and resilience.

When working with clients with suspected mitochondrial dysfunction, there’s a checklist of lifestyle changes we are likely to try. The main two of these are the reliable standbys of diet and physical activity.

Diet for Mitochondrial Health

The Mediterranean diet is the most evidence-backed eating pattern for mitochondrial health. This anti-inflammatory diet emphasizes olive oil, fish, nuts, leafy greens, berries, and legumes. It’s rich in antioxidants, micronutrients, and healthy fats that help mop up excess oxidative stress and inflammation—key enemies of mitochondria 6 7.

Even if you don’t follow the Mediterranean diet specifically, any diet that regularly provides your required daily nutrients will help keep your mitochondria humming. For many of my clients, especially those who react poorly to foods like wheat and dairy, a more suitable eating plan is a Paleo-style or even a low FODMAP-style diet.

A common thread through all these diets is low levels of refined sugar, trans fats, and ultra-processed foods. Minimizing these pro-inflammatory foods is important as they can increase oxidative damage, which may harm mitochondrial membranes.

Exercise Is Essential

Exercise is one of the most powerful tools for supporting mitochondrial health. A meta-analysis of 20 studies found that all types and levels of physical activity—especially in people with cardiovascular disease—can significantly improve mitochondrial energy production 8.

But how much and what type of exercise is optimal? A combination of high-intensity workouts, such as HIIT (high-intensity interval training), and longer aerobic sessions at a lower intensity may be best for mitochondrial health.

High-Intensity Training

High-intensity exercise is hard and fast—you’ll be working at least at an 8-out-of-10 effort and unable to speak in full sentences.

A randomized controlled trial (gold standard type of experiment) found that short, high-intensity cycling sessions were effective at improving mitochondrial function in muscle, as long as the workout triggered enough metabolic stress 9. Exercise is one of those good hormetic stressors I’ve talked about before—stimuli that help your body, including your mitochondria, adapt and become more resilient to stress over time.

A meta-analysis of studies of older adults following an HIIT program found that short bursts of intense exercise significantly improved citrate synthase activity—a key marker of mitochondrial function—in their skeletal muscle 10. Although the study did not confirm the exact mechanism, its findings suggest the benefits may have stemmed more from enhanced performance of existing mitochondria than from the creation of new ones (mitochondrial biogenesis).

Zone 2 Exercise

If you rate your perceived effort at around a 4 out of 10 and can still speak in full sentences without gasping for breath, you’re likely in the right ballpark for Zone 2 workouts (typically about 65% of your maximum heart rate). Easy runs or moderate-effort cycling on flat roads often fall into this category.

Research suggests that continuous, moderate-intensity training (such as Zone 2 training) is effective at supporting mitochondrial biogenesis—the creation of new mitochondria—particularly in skeletal muscle 11.

An advantage of lower-intensity Zone 2 exercise is its accessibility, making it easier for people with lower fitness levels to incorporate into their routine.

The bottom line? There’s still a lot to learn about the optimal dose of exercise for mitochondrial health. But a combination of Zone 2 exercise (e.g. 2–3 hours per week) and HIIT (e.g. 1–2 sessions per week) is often recommended to target different aspects of mitochondrial function.

That’s not forgetting the importance of one to two weekly strength training sessions, which also support metabolic and mitochondrial health.

If you’re new to exercise, and particularly if your exercise capacity is impaired, talk to a healthcare or fitness professional and work within your limits.

Red Light Therapy

Red and near-infrared light therapy can be a useful option for people looking to help target mitochondria dysfunction. It’s thought to stimulate mitochondria via an enzyme called cytochrome c oxidase. 

A review found that red light therapy may boost energy production and reduce harmful oxidation, improving mitochondrial function and protecting neurons (nerve cells) in the brain from damage. We have some of our clients using at-home, FDA-approved red light therapy devices with great success for fatigue, low mood, and wrinkles.

By supporting mitochondrial health, the therapy may also lower inflammation and help clear toxic proteins linked to Alzheimer’s disease, making it a promising non-drug way to slow neurodegeneration 12.

Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) floods your body with oxygen under pressure, delivering it deep into tissues. It’s also gaining attention for its potential to optimize mitochondrial function—especially when used long enough. HBOT is another treatment we find can have significant benefits for the right clients.

As far as research goes, a randomized controlled trial gave 37 middle-aged athletes either 40 HBOT sessions or a sham treatment over two years. After 40 sessions, those in the HBOT group saw improvements in 13:

• Mitochondrial respiration
• Mitochondrial mass
• Measures of fitness

In simple terms, the therapy appeared to boost both the number and performance of mitochondria, potentially enhancing the body’s capacity for energy metabolism.

But how many sessions you do seems to matter. A 2021 research review found that short-term use (1–5 sessions) of HBOT may impair mitochondrial function, but longer courses (20–30+ sessions) may consistently improve it. This may be related to the body’s adaptive response to repeated oxygen exposure, which may enhance protective systems over time 14.

In a nutshell? HBOT can meaningfully boost mitochondrial performance—but only with enough sessions. Short-term use may backfire, so working with someone who understands the nuances of treatment duration is important.

Supplements for Mitochondrial Support

There’s promising evidence that certain supplements can play a key role in restoring mitochondrial health, especially when combined with diet and exercise.

Here’s a snapshot of the science-based combinations we’ve seen work in the clinic. They’re listed from strongest evidence to more emerging options.

Mitochondria and the Cell Danger Response

When they detect threats like infections, environmental toxins, or trauma, mitochondria can trigger a defense mode called the Cell Danger Response (CDR). Think of it as your cells hunkering down during a storm to stay safe.

The CDR changes how cells behave—disrupting sleep, mood, digestion, and energy in the process. It’s meant to be a short-term response, but if the body doesn’t receive an “all clear” signal, the CDR can get stuck in a loop, contributing to chronic health issues 19.

Dr. Robert K. Naviaux, a leading expert in mitochondrial and metabolic diseases, has outlined three stages of a stuck CDR 20:

• CDR1: Chronic inflammation develops with increased infection risk
• CDR2: Metabolic disorders like diabetes develop
• CDR3: Autoimmune and neurodegenerative diseases develop

What’s striking is that the CDR may be triggered not only by physical threats, but also by past trauma and unresolved stress 19.

This means that emotional safety, connection, and nervous system regulation may be just as vital as diet, exercise, and supplements in helping mitochondria “unstick” and exit CDR mode.

I’ve found that some clients with significant mitochondrial dysfunction benefit from psychological support—such as counseling, mind-body therapies, or limbic retraining—alongside diet and lifestyle changes. If your body is effectively saying, “I don’t feel safe enough to heal yet,” deeper exploration may be necessary.

Learn more about the cell danger response in our dedicated article.

Reclaiming Mitochondrial Vitality

If you’re dealing with persistent fatigue, brain fog, or unexplained health issues, it might be time to take a closer look at your mitochondria. These microscopic powerhouses are the gatekeepers of vitality—when they’re compromised, every part of your body can feel the effects.

The good news? With rare exceptions like inherited mitochondrial disease, mitochondria are highly adaptable. Given the right fuel and support, they can recover and help your cells function more efficiently.

Start with the basics: nutrient-dense food and regular movement. From there, you might explore more advanced tools like red light therapy, targeted supplements, or—when needed—support in healing from past trauma. And if you’d like guidance, our experienced functional health practitioners at the Ruscio Institute for Functional Health are here to help.

Healing won’t happen overnight, but with consistent care, your mitochondria—and your energy—can come back online.

The Ruscio Institute has developed a range of high-quality formulations to help our clients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you. The information on DrRuscio.com is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.