Why Are Mitochondria Important?
Mitochondria are organelles present in every cell of the body except red blood cells. About 20% of our body weight is mitochondria. The accepted theory is that mitochondria were once bacterial cells that created a commensal relationship with eukaryotic cells, giving them the energy to become multicellular. Working together, multicellular organisms were able to evolve.
Mitochondrial Dysfunction and Mental Health
I became interested in mitochondria a few years back, having noticed that a certain percentage of patients with depression were quite treatment-resistant. They seemed to actually get worse with conventional psychiatric medications and did not respond well to naturopathic lifestyle and natural remedies. These patients often complained of physical exhaustion, great difficulty with exercise, headaches, brain fog and sensitivity to noise and lights. Most upsettingly, their doctors had told them their feelings were “all in their head.”
I found very strong evidence demonstrating that many mental health conditions — including bipolar disorder, depression, psychosis, personality challenges, OCD, anxiety, autism and even dementia — may have roots in mitochondrial dysfunction [1]. This makes sense: the mitochondria’s main job is to produce 36 molecules of ATP from one molecule of glucose via oxidative phosphorylation — compared to the paltry 2 ATP molecules our cells could otherwise make via the glycolytic pathway.
Neurons have a greater number of mitochondria per cell than most other cells, so it is no wonder that brain and mood are greatly affected by dampened mitochondrial function. There is greatly decreased ATP production and many increased mitochondrial DNA deletions in major depression [2, 3]. Additionally, altered calcium sequestration in the mitochondria appears to play a role in the pathophysiology of anxiety [4].
How Mitochondrial Function Becomes Compromised
A number of issues affect mitochondrial function: stress, hyperglycaemia, dysinsulinaemia, inflammation, iron and metal toxicity, and lipid peroxidation. These issues combine to increase mitochondrial DNA damage, changing the ability of the mitochondria to form the proper antiporters and ion pumps needed to maintain energy production. Once energy production ceases, ions, minerals and inflammatory molecules start moving into parts of the mitochondria, jamming up the works and encouraging mitochondrial swelling. B vitamins and NADH are used up trying to keep DNA structures intact, contributing to further mitochondrial destruction. As mitochondria are destroyed faster than they can heal, the cell becomes at risk of apoptosis — and as more cells die, more inflammation occurs, keeping the downward spiral going.
How to Test Mitochondrial Function
Unfortunately there is no single test to check mitochondrial function. However, if a patient presents with the above concerns, useful markers include serum carnitine, iron levels, CoQ10, lactic and pyruvic acid, glutathione, hormonal levels, zinc, insulin, the MTHFR gene and vitamin D. Depending on the case, organic acid testing, mold issues and oxalate overload may also be relevant.
Adrenal and HPA Axis Testing
I also like to assess the function of the Hypothalamic Pituitary Adrenal (HPA) axis. Chronic stress drives excess catecholamine production, which is directly damaging to mitochondria. Our Adrenal Function Saliva Test Kit (LCMS) measures cortisol at four time points across the day alongside DHEA-S — providing a clear picture of whether HPA axis dysregulation is contributing to mitochondrial stress and mental health symptoms.
Heavy Metal and Toxin Testing
Heavy metal toxicity — from lead, mercury, cadmium and arsenic — is one of the most significant and frequently missed drivers of mitochondrial dysfunction. Our Heavy Metals Test Kit screens for toxic and essential elements in dried blood and urine — identifying metal exposures that may be silently undermining mitochondrial and mental health.
Neurotransmitter Testing
Hormone and neurotransmitter testing can be a key to understanding which neurotransmitters need support while working on the underlying mitochondrial dysfunction. Our Neurotransmitter & Dried Urine Hormone Test measures dopamine, serotonin, norepinephrine, epinephrine, GABA and glutamate alongside urine hormones — with specialist interpretation included — providing a comprehensive neurochemical picture to guide targeted support.
A 5-Step Plan to Support Mitochondrial Repair
While there is no single treatment to heal mitochondrial dysfunction, the body typically knows how to heal when given the right supports.
1. Sleep
Obtaining 8 hours a night, with consistency and getting to bed before 11pm. Sleep is when the mitochondria clean themselves up and rebuild, and the brain de-inflames. There is no substitute for sleep.
2. Exercise
If a patient is tired, exercise should be gentle. Moving the body is important for detoxification, clearing inflammation and catalysing mitochondrial biogenesis [5].
3. Healthy Diet
Eating a mitochondria-building diet including whole foods, with plenty of healthy protein, vegetables and healthy oils, provides the nutrients and anti-inflammatory molecules needed for mitochondria to clean, rebalance and rebuild. Avoid sugary foods, simple carbs, fried foods, processed foods and foods with dyes and preservatives. The Mediterranean Diet is often the best starting point, including green tea, berries and apples for their mitochondria-building phytonutrients.
4. Relaxation and Stress Reduction
Minimising the sympathetic load will lower catecholamine production and signal the body to rebuild. Meditation, yoga, acupuncture and massage are wonderful choices. Talk therapy and Cognitive Behavioural Therapy (CBT) may be needed if anxiety and stress are promoted by thoughts.
5. Avoiding Toxins
Checking for mould toxicity, oxalates, metal exposures and any other chemical exposure present in the home or work environment. For some people with genetic tendencies to not break down toxins effectively (liver cytochrome P450 genetic SNPs), even common household exposures from rugs, cleaners, perfumes, shampoos, lotions and inorganic food may be enough to jeopardise mitochondrial function.
6. Targeted Supplementation
B complexes support Krebs cycle function; fish oil positively supports mitochondrial dynamics [6]. Direct mitochondrial supports may include carnitine, lipoic acid and nicotinamide. N-Acetyl Cysteine (NAC) encourages oxidative phosphorylation, mitochondrial membrane integrity and homeostasis. Hypericum (St. John’s Wort) — the most well-studied herb for mild to moderate depression — has also been shown to help neuronal mitochondria regenerate [7].
Conclusion
For mental health disorders, there is no one answer. Using a multifactorial approach that is individualised may have the best results. Hippocrates recommended healthy food, sunlight, exercise and herbs like St. John’s Wort some 2,500 years ago — and although mitochondria were not discovered at that time, the father of medicine had a pretty solid plan for mitochondrial dysfunction. Today, practitioners have a great deal of new information about psychiatric illness to build upon that foundation.
References
- Scaglia F. The role of mitochondrial dysfunction in psychiatric disease. Dev Disabil Res Rev. 2010;16:136–143.
- Gardner A, et al. CNS Spectr. 2008;13:805–14.
- Rezin GT, et al. Acute administration of ketamine reverses the inhibition of mitochondrial respiratory chain induced by chronic mild stress. Brain Res Bull. 2009;79:418–21.
- Schweitzer N. Pegging pathology on mitochondrial dysfunction. Scientist. 2004;18:28.
- Lumini JA, et al. Beneficial effects of exercise on muscle mitochondrial function in diabetes mellitus. Sports Med. 2008;38(9):735–50.
- Sun R. Dietary supplementation with fish oil alters the expression levels of proteins governing mitochondrial dynamics. Br J Nutr. 2014;112(2):145–53.
- Wang et al. Hyperforin promotes mitochondrial function and development of oligodendrocytes. J Neurochem. 2011;119(3):555–68.
- Bongiorno PB. Holistic Solutions for Anxiety & Depression. W.W. Norton, New York (2015):244–261.
Originally ZRT Laboratory. Reproduced with permission. Last reviewed: May 2026.