Mitochondrial Dysfunction and Aging
By Charles Kamen, MD, board-certified neurologist
Mitochondrial dysfunction is recognized as a central mechanism of biological aging: as these cellular power plants falter, they produce less ATP — the body's primary energy currency — and the tissues that demand the most energy tend to age fastest.
Dr. Charles Kamen, MD, a board-certified neurologist at LiveNow Longevity in Las Vegas, assesses mitochondrial function as part of comprehensive longevity care, because cellular energy sits underneath almost every healthspan goal — from a sharper mind to better recovery. Individual results vary.
What Are Mitochondria?
Mitochondria are the organelles inside your cells that produce ATP — the body's primary energy currency — by converting nutrients into usable energy through oxidative phosphorylation. The more energy a tissue burns, the more mitochondria it carries and the more it depends on them working well. [1]
Beyond energy production, mitochondria regulate apoptosis (programmed cell death), calcium balance, heat production, and cellular signaling. They carry their own DNA and replicate independently within the cell.
Why Is Mitochondrial Dysfunction Central to Aging?
Because mitochondrial output declines with age through several converging mechanisms, and once energy production falls, the energy-dependent repair and maintenance processes throughout the body slow with it. This is why mitochondrial dysfunction is grouped among the core hallmarks of aging, interacting with and amplifying the others. [2]
- Accumulated mitochondrial DNA mutations reduce energy-production efficiency
- Declining CoQ10 levels impair electron transport chain function
- Impaired autophagy allows damaged mitochondria to accumulate
- Reduced mitochondrial biogenesis limits replacement of worn-out organelles
- Falling membrane potential lowers ATP-production capacity
Which Tissues Suffer Most From Poor Mitochondrial Function?
The tissues with the highest energy demands — brain, heart, skeletal muscle, and endocrine organs — decline first and fastest when mitochondria underperform. That is why mitochondrial aging tends to show up as cognitive fog, reduced exercise capacity, and metabolic dysfunction rather than as a single isolated symptom. [2]
In skeletal muscle, declining mitochondrial capacity tracks closely with the loss of strength and stamina seen with age [3], while in the brain, cellular energy status is increasingly linked to mood, stress resilience, and cognition [4] — an overlap Dr. Kamen watches for as a neurologist.
How Does Dr. Kamen Assess Mitochondrial Function?
Mitochondrial health cannot be captured by a single test, so Dr. Kamen pairs biochemical markers with real-world performance. Together these reveal how efficiently your cells are turning fuel into energy and where the bottlenecks sit:
- Organic acids testing: identifies intermediates of mitochondrial energy production
- CoQ10 levels: CoQ10 is essential for electron transport chain function
- Lactate-to-pyruvate ratio: distinguishes cytoplasmic from mitochondrial energy metabolism
- Creatine kinase: a marker of muscle-cell membrane integrity
- Physical performance: VO2 max and functional testing reveal real mitochondrial capacity
How Can You Support Mitochondrial Function?
You support mitochondrial function by supplying its key cofactors and by giving cells the right stress signals to build new, healthier mitochondria. NAD+ and CoQ10 are critical cofactors for energy production, while resistance training and fasting prompt the body to renew its own mitochondrial pool — supporting energy, recovery, and cellular health together.
- NAD+ IV therapy: NAD+ is an essential cofactor for mitochondrial energy production, and IV delivery bypasses digestive absorption limits
- CoQ10 supplementation: supports electron transport chain function
- PQQ (pyrroloquinoline quinone): supports mitochondrial biogenesis
- Alpha-lipoic acid: supports mitochondrial antioxidant defense
- Resistance training: stimulates mitochondrial adaptation in muscle
- Intermittent fasting: promotes mitochondrial cleanup and replacement
- Sleep optimization: allows overnight mitochondrial recovery processes
A Neurologist's View: Mitochondria, Energy, and the Brain
The brain is one of the most energy-hungry organs in the body, so when mitochondrial output falls, mental energy and clarity are often among the first things to suffer. Work in mitochondrial psychobiology links cellular energy status to mood, stress resilience, and cognitive performance. [4]
As a neurologist, Dr. Kamen sees fatigue and brain fog daily that stimulants never fully fix — because the shortfall is in cellular energy production, not alertness. Restoring mitochondrial function is often what returns steady daytime energy, sharper focus, and better recovery.
Key Takeaways
- Mitochondria produce ATP — the body's primary energy currency — and also regulate apoptosis, calcium balance, and cellular signaling.
- Mitochondrial dysfunction is a central mechanism of biological aging and interacts with the other hallmarks of aging.
- High-energy tissues — brain, heart, and skeletal muscle — are affected first when mitochondrial function declines.
- NAD+ and CoQ10 are critical cofactors for mitochondrial energy production; exercise and fasting stimulate new mitochondria.
- Some improvements can appear within weeks, but significant adaptations typically require 3-6 months of consistent effort.
- Dr. Kamen assesses and supports mitochondrial function as part of longevity care in Las Vegas.
Common Questions
How do I know if my mitochondria are functioning poorly?
Dr. Kamen combines organic acids testing, CoQ10 levels, a lactate-to-pyruvate ratio, and physical performance measures like VO2 max to evaluate mitochondrial function. Symptoms such as persistent fatigue, exercise intolerance, and cognitive fog can suggest mitochondrial involvement, but testing is needed to confirm where the energy bottleneck actually lies.
What is NAD+ IV therapy?
NAD+ (nicotinamide adenine dinucleotide) is an essential cofactor your mitochondria use to produce energy, and levels tend to fall with age. Intravenous administration bypasses the absorption limits of oral supplements, delivering NAD+ directly into circulation. Our Las Vegas clinic offers NAD+ IV therapy as one tool for supporting cellular energy.
Can mitochondria be repaired or replaced?
Yes, to a meaningful degree. Mitochondria have some capacity for internal repair, and both exercise and fasting stimulate mitochondrial biogenesis — the creation of new mitochondria. Damaged organelles are also cleared through autophagy, the cell's quality-control process, letting healthier mitochondria take their place over time.
Will improving my mitochondria give me more energy?
Often, yes. Because mitochondria generate the ATP that powers every cell, improving their function is one of the most direct ways to restore steady daytime energy — especially the fatigue and brain fog that caffeine never quite fixes. Individual results vary, and the underlying cause should be identified first through testing.
Does CoQ10 supplementation really help?
CoQ10 is essential for electron transport chain function, the step where most cellular energy is produced. Supplementation may help when levels are low, which becomes more common with age and with certain medications. Dr. Kamen tests CoQ10 status and recommends supplementation only when the results indicate it is warranted.
How long does it take to improve mitochondrial function?
Some improvements can occur within weeks of starting a targeted protocol, particularly with better sleep, training, and cofactor support. More significant adaptations — new mitochondria and measurable performance gains — typically require 3-6 months of consistent effort. Progress depends on your starting point and how closely the plan is followed.
Mitochondrial dysfunction is a treatable component of biological aging, and supporting cellular energy is one of the highest-leverage moves you can make for your healthspan. Schedule a consultation with Dr. Kamen to assess your mitochondrial function and develop a personalized support protocol.
References
- Nunnari J, Suomalainen A. Cell. 2012;148(6):1145-1159. (Mitochondria: in sickness and in health).
- Li Y, et al. Aging Cell. 2024;23(1):e13942. (Interactions between mitochondrial dysfunction and other hallmarks of aging).
- Gonzalez-Freire M, et al. J Cachexia Sarcopenia Muscle. 2018;9(3):435-440. (Searching for a mitochondrial root to the decline in muscle function with ageing).
- Picard M, Trumpff C, Burelle Y, et al. Curr Opin Behav Sci. 2019;28:142-151. (Mitochondrial psychobiology: foundations and applications).
Wondering what’s right for you?
Get a straight answer from board-certified neurologist Dr. Charles Kamen, MD. The evaluation is $88 and is applied toward your protocol if you continue care.