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An Introduction to Four Supplements for Lyme Disease, Mitochondrial Dysfunction, and Mental and Physical Fatigue

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Fatigue is one of the most common complaints among Lyme disease patients. Most of us have heard the well-meaning friend or family member say, “Oh, I’m tired too,” when we voice our reasons as to why we might not be able to participate in a particular activity or event due to our level of fatigue. Simply put, this is an inaccurate view of a complex problem, and the standard levels of tiredness that healthy people experience after working a long day or having a bad night’s sleep are not the same as the fatigue related to an illness. Rather, the sort of exhaustion associated with a chronic condition is best explained, by those of us who are dealing with it on a daily basis, as feeling completely drained or devoid of energy. Some days, we’re lucky just to have the strength to lift our heads from our pillows.
There are many reasons we develop this profound sense of exhaustion: our bodies are fighting a whole host of infections. Our adrenal glands are likely overtaxed. Our thyroid gland might be over or underactive. Our sleep may be disrupted by insomnia or pain. There could be genetic factors impeding our body’s ability to detox. Or, we may lack vital nutrients to adequately make energy. Lastly, we may also experience severe energy depletion due to mitochondrial dysfunction.
Let’s examine some of the functions of the mitochondria.
Mitochondria are nicknamed “the powerhouse of the cell” for their ability to carry out the necessary chemical processes that make energy; they are the “energy furnaces” of the cell. “In some, the mitochondrial energy furnaces are defective and cannot keep up with the energy demand of cells and tissues as they work through daily activities. For others, cells and tissues are deficient in certain nutrients that are needed to process food into energy, leaving the tissues energy-starved…No matter the cause, energy depletion causes a downward spiral of fatigue, muscle pain, and stiffness that will not stop until the energy in the affected tissues can be restored,” wrote Dr. Jacob Teitelbaum, MD in From Fatigued to Fantastic (2007, p.29).
Is it possible to improve the function of your mitochondria and regain some liveliness? Yes, it is! There are many ways to optimize energy production in the body, and it will involve some trial and error to find what works for you. Like many things Lyme-related, it can take several weeks to months to notice an improvement in your energy, but don’t give up.
Following are some of the supplements that may help to combat fatigue and help support energy production as you heal from Lyme disease.
1. CoQ10- CoQ10, also referred to as “ubiquinone,” is a critical nutrient for every cell in your body to produce energy. It also helps your body preserve other antioxidants like vitamin C and E. Although it’s often found in food, when extreme energy requirements are placed on the body (such as, when you’re fighting a barrage of infections), CoQ10 levels may become depleted. Low levels can affect the heart, brain, your overall energy levels, immune function, and more. Your physician can order a blood test to detect your CoQ10 levels. Effective CoQ10 dosages may range from 100 mg to 400 mg depending on your test results and your list of symptoms, states a 2011 article for Pro Health by ME/CFS expert, Dr. Sarah Myhill, MD.  
Note: If you’re taking Mepron or Malarone, you may need to avoid CoQ10 as it can interfere with the way in which those medications work.  
2. D-Ribose- D-ribose is a unique, beneficial sugar that the body utilizes to produce energy molecules that feed muscle cells such as the skeletal muscles and heart. Additionally, daily intake of this supplement looks compelling for those suffering from ongoing fatigue, pain, and muscle tension. Since D-ribose sometimes lowers blood sugar, some people find that it works best to take it with food. Dosages may vary depending on your physician’s preference. Some patients may experience a side effect of feeling overstimulated, anxious, or hyper. If this occurs, reduce the amount you’re taking until that side effect disappears.  
3. Acetyl-L-Carnitine- L-carnitine is an amino acid-like compound that is manufactured for the body from meat sources and helps the brain make acetylcholine—a neurotransmitter that helps nerve cell signaling. But patients with Lyme disease or other chronic illnesses may be deficient in this neurotransmitter, leading to symptoms like mental and physical fatigue, poor memory, and impaired cognition. Acetyl-L-carnitine is a more readily absorbable form of L-carnitine, because it crosses the blood-brain barrier more easily, and supports energy production within the brain cells. Effective dosages can start as low as 500 mg and go as high as 3,000 mg. It’s generally well-tolerated. However, Prescription for Natural Cures lists skin rashes, body odor, and digestive upset as potential side effects.
4.NADH (Nicotinamide Adenine Dinucleotide)- NADH is a form of vitamin B3, and it supports healthy cellular energy production and metabolism—among other things. It may be beneficial for patients with ongoing fatigue and depression. NADH appears to be safe for most people, but talk to your doctor about dosing instructions. Dosages related to Lyme disease range from 5 mg to 100 mg.
This list describes just some of the supplements that may support proper energy production in patients with Lyme disease. I’d love to hear from you about the things that have helped you reclaim your energy. Please feel free to leave me a comment below!
Balch, J.F., & Stengler, M. (2004). Prescription for Natural Cures. Hoboken, NJ: John Wiley & Sons.
Myhill, S. (2011, June 22). Dr. Sarah Myhill on Coenzyme Q10 in Chronic Fatigue Syndrome (ME/CFS). Retrieved from

Teitelbaum, J. (2007). From Fatigued to Fantastic. New York, NY: The Penguin Group. 

Jenny Lelwica Buttaccio, OTR/L, is an Occupational Therapist and certified Pilates instructor whose life was transformed by Lyme Disease, Chronic Fatigue Syndrome and Interstitial Cystitis. She is creator of the DVD, New Dawn Pilates: pilates-inspired exercises adapted for people with pelvic pain. Jenny is a health and wellness advocate and blogger who writes about her journey on [] as she continues to pursue her personal healing with the support of her husband and two senior beagles. You can find her on Instagram: [jenny_buttaccio] or Twitter: [lymeroad]

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