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Create Vital Energy: From Mitochondria to Sex

We Are Energy

We are energy at our most fundamental level. Energy is the expression of all action, function, and feeling associated with being alive and human. This includes biological energy in all its various forms—passion, vitality, curiosity, and life force—that are all connected, and that we lose when we are ill. The greatest blow of chronic illness is the loss of vital energy and how this impacts all aspects of our lives—how we think, create, connect, love, and live.

Our work to recover energy has its roots within the body, where energy is created. Supporting the production of chemical energy inevitably leads us to the vitality we seek. The in-roads to our healing and recovery of vital energy is grounded within The Nine Domains of Healing. We will all need a different strategy for energy recovery based on our unique needs and preferences.

There is no better measure or indicator of successful healing than our sense of energy and wellbeing. There are no biomarkers of good health more accurate than our own subjective experience of energy and vitality. The ultimate expression of a healthy and balanced body, mind, and spirit is good energy.

Overview of What We Need for Optimal Energy Production:

Breath: inhalation supplies oxygen; exhalation removes carbon dioxide; breathing modulates nervous system control via the parasympathetic nervous system.

Energy nutrients: derived from food to support all aspects of chemical energy production and protection of cells and tissues from oxidation (toxic aftermath of energy chemistry)—includes vitamins, minerals, fats, anti-oxidants, and specialized molecules.

Hydration: water assists with circulation of blood and body fluid elements and participates in the chemistry of energy production.

Sleep: allows for restoration and repair by facilitating circulation, modulating the stress response, supporting detoxification, allowing circadian control of hormones.

Movement: aids in circulation of blood and body fluids, decreases oxidative stress (cleans up after energy production) when not in excess, and reduces inflammation.

Circulation of blood, lymph and tissue fluid: brings in water and nutrients, removes toxins, maintains adequate blood pressure to perfuse tissues and cells.

Detoxification by liver, gastrointestinal tract, kidneys, breath, skin, and brain: removes toxins and irritants that hinder energy production.

Healthy gut and microbiome: provides nutrition through healthy digestion and absorption, eliminates toxins, reduces inflammation and immune activation.

Oxygen and energy nutrition: conduct the chemistry of energy production, anti-oxidants clean up toxic aftermath of energy chemistry.

Thyroid glands and thyroid hormones: thermostatic regulators that support cellular work sustained by energy; places increased demand on energy resources.

Adrenal glands and hormones: support the availability of fuel (carbon fragments from glucose and fatty acids) for energy production; sustain blood pressure and circulation to deliver them.

Mitochondria: sub-cellular organelles where oxygen and energy nutrients manufacture chemical energy in the form of ATP.

We are Powered by Chemical Energy

We depend on a robust supply of chemical energy to drive all processes of the body. Chemical energy is made within the billions of tiny organelles, contained within virtually every cell, called mitochondria. The amount of energy produced in our bodies depends entirely on need and is orchestrated by our genes, environmental influences, and the vast physiologic resources that we devote to fueling ourselves. Every action, function, growth, repair, thought, and experience requires energy, and these infinitesimal needs of our bodies will be communicated, and ultimately become manifest, within those tiny, powerhouse organelles.

Energy production is driven and supported by many essential nutrients, acquired from the food we eat, the water we drink, and the oxygen we breathe in, that run the chemistry. Our ability to make energy is so necessary to every aspect of our lives that we devote a great deal of geography (metaphorically speaking) and countless layers of biochemistry to creating and preserving it. The making of energy is an extraordinary and elaborate physiological symphony of chemical processes. In addition to the mitochondria, where chemical energy is manufactured, there are critical levels of control from the brain, thyroid gland, and adrenal glands, which we will explore in detail later on in this chapter.

In addition to the drivers of energy production, we must concern ourselves with interferences to energy production. These included nutrient deficiencies, dehydration, suboptimal sleep, chronic activation of our stress systems, lack of sufficient movement, toxins, irritants, infections, and inflammation. Our detoxification systems (circulation of blood and body fluids, liver, GI tract, kidneys, breath) sweep away toxins that impair energy production, including those created by energy production itself. Sleep and rest support detoxification and allow for needed restoration from the effort and physical challenges of being alive. Breath and blood bring in oxygen and nutrients and carry away toxins.

Energy Chemistry: ATP Production

Humans, and all mammals, generate chemical energy in the form of adenosine triphosphate, or ATP, through a three-part process of energy chemistry, which takes the energy potential from our food and converts it into energy we can use in our bodies. The three parts of this chemistry have names: glycolysis, the tricarboxylic acid cycle (also widely known as the “Kreb’s cycle”), and electron transport.

For biochemistry geeks, read on. All others please skip the next few paragraphs for your sanity!

Glycolysis is the first phase of energy production, conducted within the cell’s cytoplasm, where the six-carbon glucose molecules (derived from our food or made by our livers) are transformed into a smaller sugar, pyruvate, while releasing energy in the process. Nothing in the body is wasted, so the energy released by glycolysis will be absorbed by electron-carrying molecules to form ATP and NADH, both storage forms of chemical energy.

Pyruvate then enters the power centers of the cell, the mitochondria, where it is broken down further into the two-carbon sugar, acetyl-CoA, releasing carbon dioxide. Acetyl-CoA generates more ATP as well as electron carriers through the multi-step tricarboxylic acid cycle. Each step of this process is orchestrated by genetic control and the availability of necessary nutrients.

Finally, the electron carriers produced in glycolysis and the tricarboxylic acid cycle, the first two stages of energy production, enter electron transport within the mitochondria. This is where electrons are transferred from one constituent of the electron transport chain to the next, eventually leading to the capture of energy by oxygen, producing more ATP, and releasing carbon dioxide, water, and free radicals. The carbon dioxide is rapidly removed and the free radicals are quenched by antioxidant nutrients such as glutathione, selenium, vitamins C and E. The ATP is the chemical energy contained within each cell that is used to fuel all of its work.

When glucose is not available, fats called triglycerides are used to make energy. These are consumed in our diets and produced in our livers and adipose tissue as storage forms of fat. Triglycerides consist of three fatty acids attached to a glycerol backbone. These complex molecules are dismantled within the mitochondria via a process known as beta-oxidation, which leads to the production of acetyl-CoA, the same 2-carbon sugar made in glycolysis, which goes directly into the tricarboxylic acid cycle, followed by electron transport, to make ATP.

Unlike glucose, triglycerides cannot penetrate the blood-brain barrier to get into the brain. Nor can the brain utilize anything other than glucose or ketones for energy. To this end, the liver mitochondria, in the absence of glucose availability, will use acetyl-CoA derived from fatty acids to manufacture ketones, which can cross the blood-brain barrier and are readily used by brain mitochondria to make ATP. Skeletal muscle can also utilize ketones for energy and with time will switch their metabolism to allow for the direct use of fatty acids when glucose stores are consistently low. The process by which skeletal muscle switches its energy metabolism from ketones to fatty acids is known as keto-adaptation and is a gradual process that can take weeks to develop.

Energy Starts With Breath

Breath is where is all begins. Breathing is so vital a function that it goes on automatically, without our conscious attention. Breath allows for the ingress of oxygen, the electron acceptor that allows us to make ATP, the chemical energy used for all energy-dependent processes in the body. We exhale carbon dioxide, one of the chemical end products of energy production, which must be eliminated regularly as it is toxic in excess.

Deep conscious breathing stimulates the parasympathetic nervous system (PSNS) through contraction and descent of the diaphragm and activation of the vagus nerve. This calms, slows, and balances the more stimulating effects of our nervous system, allowing us to reduce excesses of the stress response, and thus conserve energy. Deep conscious breathing has the power to shift us away from the damaging potential of excessive stress, inflammation, and oxidation.

Breath allows us to smell and taste our world, bringing in information about the food that we need to eat to power the energy production apparatus of our bodies, or to alert us to what we must avoid. Molecules from our environments are carried in with the moisture in our breath, allowing us to assess the information within them. Do they smell good? Inviting? Nourishing? Hazardous? Many important decisions are made this way both consciously and unconsciously.

We can use our breath to concentrate our intention and sustain intensity in the body, such as when exercising, holding a challenging position, managing pain, or modulating difficult emotions—all energy conserving. We can use breath to pull our consciousness deeply within the body, allowing us to mitigate physical energy and balance emotional energy.

Breath is the magical and, perhaps, mystical junction between chemical energy and life force, the collision of mighty forces with a single focus. The literature from many traditions note the profound benefits of deep, focused breathing on our health, mitigated through the energy systems of the body. These include a greater sense of calm and equanimity, improved mood and cognitive abilities, enhanced creativity and productivity, greater awareness of the body, reduced pain, and positive shift in biomarkers for health—such as blood sugar, inflammatory indicators, hormones, and immune function.

The Nourishing Power of Sleep

I know of no healing modality that goes deeper than sleep. Deep sleep is often a game changer for those who are suffering from fatigue. Sleep deprivation or suboptimal sleep is often an important contributor to my clients’ illnesses, and sleep restoration is always an important part of their healing. Sleep is a time when deep repair and restoration occurs for all of our bodies’ vital processes. It is the ultimate re-set for both our bodies and our minds, providing a multitude of vital functions to support energy.

What constitutes normal sleep is highly variable and depends on the individual and their needs at any given time. Many of my clients recovering from chronic, complex illness require more sleep than average and find spending more time in bed and napping during the day to be very productive for their healing. My client, Nancy, was very sick with Lyme disease and needed to take a scheduled two-hour nap every day in addition to the nine to ten hours she slept at night. It simply was what she needed and she found it to be deeply restorative. Before her illness she was on the go all of the time and would have thought of napping as pure laziness. After her experience with severe illness and the power of sleep she became enlightened. Now that she has recovered she naps less but honors her need for more rest. It is quite possible that her previous practice of not allowing for adequate rest and restoration facilitated the severity of her illness.

The Big Hormonal Energy Picture: The Brain-Thyroid-Adrenal-Mitochondrial Axis (BTAM Axis)

This critical aspect of energy production is covered in Energy Recovery 101: Root Cause Solutions for Healing your Adrenals, Part One and Part Two.

The Biochemistry of Fatigue: What Can Go Wrong

ATP production, our chemical energy, is driven by our complex physical, mental, and emotional needs and is supported by the many essential nutrients running the chemistry. Many things can go wrong with this system: persistent stress, illness, nutrient deficiencies, toxins, impairments in detoxification systems, infections, inflammation, and autoimmunity, all can damage the brain control centers, the thyroid and adrenal glands, and interfere with communication between each of the vital components of the system. These problems ultimately derail the signaling necessary to manufacture and deliver the energy, in the form of ATP, that we need. This is the biochemistry of fatigue.

Chronic Fatigue Syndrome

This term represents the medicalization of persistent fatigue that does not seem to have a cause or a cure by conventional medical standards. Chronic fatigue syndrome is a descriptive diagnosis only and does not represent a singular illness. The typical symptoms of chronic fatigue syndrome are persistent fatigue, poor exercise tolerance, diffuse myofascial pain, insomnia, brain fog, and gut disturbance—all manifestations of energy deficit throughout the body. The fatigue and related symptoms are quite real and the impact is often catastrophic for the people who experience it, but there is always a cause or causes. There is always a reason why energy production becomes impaired. There are as many causes for persistent fatigue as there are people who experience it. I’ve yet to work with a client suffering from chronic fatigue who does not have identifiable points of dysfunction that can be corrected. The systems biology approach of Functional Medicine and body-mind principles, presented through the Nine Domains of Healing roadmap, allow us to dig deeply into the roots of energy production and the many potential causes of chronic fatigue.

Caffeine and Alcohol

Our favorite drugs. Both have health benefits for many of us at optimal doses. In excess, both can be toxic and cause great harm. In my opinion, when someone is struggling with fatigue or a chronic complex illness for which fatigue is a major factor, it is best to avoid both caffeine and alcohol—at least until we’ve reached the point of recovery.

Caffeine is a stimulant. It acts by inhibiting specialized receptors in the brain for adenosine, an inhibitory control molecule for many neurotransmitters. Therefore, ingestion of caffeine, which is rapidly absorbed and can cross into the brain, leads to elevations in norepinephrine, dopamine, serotonin, acetylcholine, GABA, and glutamate. The effects of these chemical changes induced by caffeine’s influence on adenosine receptors include an increase in arousal and vigilance, and decrease in fatigue.

It seems intuitive that someone who is tired might want the benefit of using a stimulant drug to lift energy, mood, and motivation. The problem is that caffeine drives a need for increased chemical energy production and utilization of precious resources within a system that is already compromised and vulnerable. To place increased demand on any aspect of the energy system—the mitochondria or adrenals, for instance—is to create additional stress within the system and further loss of reserve.

Alcohol, or ethanol, produced by fermentation of sugars by yeasts, is a neurotoxic, mood-altering drug. While there are well known health benefits from consuming fermented beverages of various kinds within very specific dosage ranges, in excess it is always toxic and will lead to serious health problems. For those who are ill and have compromised physiologies, alcohol consumption will compound the problem. Alcohol must be biotransformed by the liver detoxification systems before being eliminated by the body. Liver detoxification is highly energy dependent. When energy is already low, the reserve for detoxification is likewise low. The potential for heightened toxicity is increased and the risk for further impairment of energy production due to the loss of nutrient reserve is increased.

Energy Nutrition

See Energy Nutrition and Nutritional Ketosis for Energy Recovery.

Beyond Energy Chemistry and Physiology: Life Force and Libido

As human beings we are obviously not consciously thinking about the microscopic level of energy production on a day-to-day basis. The mitochondria, thyroid, and adrenals are fascinating but we don’t sense them directly. We begin to associate our subjective experience with what we think may be going on. Oh, must be my adrenals again! What we actually experience is our relative level of vitality. When we are profoundly tired, we are squashed. Not only do we not have the energy to sustain a lot of action, we generally don’t feel happy, curious, imaginative, or inspired. These are aspects of our active humanness that are powered by energy. They constitute our life force—the elements of being alive and fully human. This is what matters to us.

Part of our life force energy is libido, our interest in being connected sexually. A near universal experience for those struggling with chronic illness and chronically low energy is loss of their usual libido. There simply is not enough energy in the tank to fuel this level of interest and the actions required to sustain a sexual relationship. There are many reasons for libido to wane. It is a complex issue that is affected by many physical as well as emotional factors, including the condition and idiosyncrasies of the relationship, stress and distraction, habit, and social and cultural factors. By working on energy recovery through the Nine Domains of Healing, libido will likewise recover. As energy reserve is created through essential self-care, there is more energy available to us for the non-essential, yet important, aspects of our lives.

Karyn Shanks MD


Karyn Shanks, MD, is a physician who lives and practices in Iowa City. Her work is inspired by the revolutionary science of Functional Medicine, body-mind wisdom, and the transformational journeys of thousands of clients over her twenty-eight year career. She believes that the bones of healing are in what we do for ourselves.

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