In my practice, it’s not unusual for a new patient to arrive with this complaint: they’re feeling wiped out, exhausted, virtually sleepwalking through their day. That lack of energy is even making them look old well before their time. Sure, there could be any number of reasons for this energy drain, but here’s one factor that’s almost always in the mix. These folks aren’t treating their mitochondria right and, in return, their mitochondria are letting them down. 

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Mitochondria are the trillions of microscopic energy factories inside your cells that provide much of the power needed to run the body. They combust the food you eat and oxygen you breathe into the energy that runs the biochemical reactions in just about every cell you’ve got. We’re talking about everything from the production of essential enzymes and hormones to the firing of your muscles to powering up your brain.

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When we’re young, we have more than enough mitochondria to go around. But over time, their size and quantity decrease. Picture a bunch of powerplants starting to go offline. Without them, we lose a good bit of our youthful vim and vigor. In fact, research now suggests that mitochondrial decay is a key contributor to the aging process and to any number of age-related diseases, including ones that impact the brain and the cardiovascular system.

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The good news is that we have a good bit of say over how slow or fast we age, and a lot of that leverage has to do with how well we care for our mitochondria. For them to thrive, healthy habits are non-negotiable – think essentials like a low-sugar, whole foods diet, restorative sleep, plenty of movement, tamping down stress, plus some exposure to both sun and cold. But you can also give your ‘mitos’ an added boost with some carefully chosen supplements. The right combo of habits and supplements translates to more energy, enhanced mental sharpness, fewer body aches and pains and an added layer of protection against the most common and dreaded diseases of aging. There’s no better therapy than that!  So, where to start? Here's my list of top ten mitochondrial health winners for you to pick and choose from, based on your unique needs:

1) Acetyl-L-carnitine

Acetyl-L-carnitine plays an important role in the body’s fuel system, helping to deliver fatty acids in the bloodstream – broken down from the fat we consume in our diets – into the mitochondria where they’re burned for energy. But, as with many things, our levels decline with age, so it’s a good idea to consider an L-carnitine supplement to help keep your mental and physical energy tank topped up.

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If you’re in good health and already getting enough carnitine from the animal protein in your diet, you’ll likely feel only a slight energy lift with a supplement. But, for those who avoid meat or dairy, the boost of an L-carnitine supplement should be felt more strongly. Studies suggest supplementation may also help counter the fatigue experienced by patients with conditions like chronic fatigue syndrome and possibly helpful for those with multiple sclerosis. There’s also some intriguing evidence that supplementation can help boost strength and over-all robustness in older people without any special medical conditions. 

2) Alpha-Lipoic Acid

Alpha-Lipoic Acid, or ‘ALA,’ is an antioxidant that’s been shown to help reduce oxidative stress in mitochondria, keeping your cellular powerplants running strong. It’s often paired with CoQ10 and L-carnitine to further enhance the health benefits. Present in every cell of your body, ALA also helps beat down inflammation, lower blood sugar levels, supports your body’s supply of collagen fibers, assists with the removal of heavy metals and the detoxification of the liver. Simply put, ALA has your back. Although your body does produce ALA, it doesn’t make large enough quantities to offset age-related decline, so consider taking an alpha-lipoic acid supplement to help fill the gap.

3) Apigenin

Apigenin  is truly a “good-for-what-ails-you” micronutrient. It’s a flavonoid, which means that at the cellular level, it works to neutralize free radicals, putting the brakes on oxidative stress. At the macro level, it’s a potent anti-inflammatory, helping to tamp down the Inflammation that drives so much of the “diseases of aging.”

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Apigenin also helps promote the formation of new mitochondria, mission critical when it comes to maintaining energy production and overall cellular function. It also boosts autophagy, your body’s cellular salvage and recycling system, whereby old dinged-up cells are stripped for parts to build brand-new cells. My advice? Don’t fall short. It’s a real must-have for aging bodies and the health of their mitochondria. 

4) Coenzyme Q10

Like ALA, Co-enzyme Q10 or CoQ10 for short, is known for its ability to help reduce oxidative stress and enhance mitochondrial energy production. CoQ10 has shown benefit in reducing fatigue and improving symptoms associated with chronic diseases, especially heart disease. In my book, maintaining healthy CoQ10 levels is so important, I recommend supplementation to the majority of my patients, particularly those over 40 who may be battling fatigue or dealing with cardiovascular issues.

And if you are on a statin to lower your cholesterol, then maintaining high levels of CoQ10 is even more important as statins can slash your CoQ10 levels by as much as 40%, leaving you vulnerable to any number of health problems, including reduced mitochondrial function. You want to consider supplementing with ‘MitoQ’ the synthetic version of CoQ10 which has significantly improved bioavailability and improved penetration compared to CoQ10.

5) Magnesium

Magnesium is a naturally occurring mineral that’s an important cofactor (or “helper molecule”) for hundreds of complex chemical reactions in the body. These reactions are critical for functions like DNA synthesis, nervous system regulation, neurological function and, you guessed it – energy production. It acts as an antioxidant, protecting against oxidative stress and promoting ATP energy production. Often called the ‘energy currency’ of our cells, ATP (adenosine triphosphate) stores and transfers energy within a cell, powering countless cellular processes. Keeping the body stoked with a steady supply of ATP ensures that our organs, muscles, and brain operate at peak capacity.

‍6) Urolithin A

Urolithin A, or ‘UA,’ is a natural metabolite produced by your gut bacteria. It helps your body thrive by protecting your cells from the cumulative effects of wear and tear, and perhaps most importantly, by energizing your mitochondria. UA also helps combat the natural decline of mitochondrial function by triggering mitophagy, the cellular recycling process that clears out old, inefficient, or dysfunctional mitochondria and replaces them with new, high-performing ones. The result? More energy, improved muscle strength and endurance and, ultimately, a body that functions more like a well-oiled machine, no matter how the years add up.

7) Methylene Blue

Methylene blue (MB) supports health by mitigating neuroinflammation and taming oxidative stress at the mitochondrial level. It also acts as an alternative electron carrier, facilitating electron transport and increasing ATP production – meaning more energy for you, on demand. Though the research is still in its early days, MB's ability to enhance mitochondrial function and energy production may prove especially beneficial for treating neurodegenerative diseases.

8) Melatonin

Most people are familiar with melatonin as a supplement for sleep support and as an all-round antioxidant. It turns out, it’s got more up its sleeve. It helps promote mitochondrial fusion -- the mitochondria merge and are able to produce more energy – as well as biogenesis, the creation of new mitochondria. Melatonin also encourages mitophagy, the clearing out of damaged mitochondria, crucial for maintaining optimal energy production. It also protects the size and distribution of the mitochondria within the cell which, in turn, can protect against cardiovascular, metabolic and neurodegenerative diseases, and even cancer.

9) N-acetyl cysteine (NAC)

N-acetylcysteine (NAC) is the supplement form of cysteine and a powerful antioxidant. NAC is beneficial for a number of bodily functions, helping to nourish the brain, reduce oxidative stress and improve mitochondrial function. NAC is a derivative of the amino acid cysteine and serves as a precursor necessary for the synthesis of glutathione (GSH). GSH protects your mitochondria by scavenging free radicals and reducing oxidative stress inside them. And NAC also helps stimulate the formation of new mitochondria, good news for those who suffer from conditions related to mitochondrial dysfunction or whose mitochondria may simply be declining with age.

10) 1-MNA

Methylnicotinamide or 1-MNA is produced by the body when it breaks down niacin in food, niacin being a form of vitamin B-3 which should tell you that it’s crucial for energy production because that’s what the Bs are all about. While there are foods that are relatively rich in 1-MNA, like celery and Chinese black mushrooms, in order to significantly shore up the body’s supply, which like most everything declines with age, you would need to go the supplementation route. Even though the research is still in the early phase, it’s still something you might want to consider. The compound is showing great promise as a mitochondrial function booster, reducing oxidative stress and helping to maintain the membranes that house the mitochondria. What might that mean for you at the macro level? Protection against cardiovascular disease looks to be the number one pay-off but 1-MNA shows promise pushing back against most of the other common diseases of aging as well.