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4 Supplements for Mitochondrial Dysfunction and 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 extreme fatigue. Simply put it bluntly: 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, one of the more common Lyme disease symptoms. 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.

Mitochondrial Dysfunction and Extreme Fatigue

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 natural therapies 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 vitamins and 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 you’re fighting Lyme disease and coinfections), 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.

Note: If you’re taking Mepron or Malarone for Babesia, 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. Side effects associated with it include body odor and digestive upset.

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 during Lyme disease treatment. 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!

This article was first published on ProHealth.com on August 23, 2017 and was updated on January 14, 2020.

ProHealth Editor and Content Manager 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, A New Dawn Pilates: pilates-inspired exercises adapted for people with pelvic pain. Jenny is a health journalist who writes about her journey on The Lyme Road as she continues to pursue her personal healing with the support of her husband and two rescue pups. You can find her on Instagram: @jenny_buttaccio or Twitter: @jennybuttaccio.


Balch, J.F., & Stengler, M. (2004). Prescription for Natural Cures. Hoboken, NJ: John Wiley & Sons.

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


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