Got patients complaining of fatigue after a viral illness? Exhaustion is rarely caused by just one thing. And it is possible that part of why your patient is so exhausted is their mitochondria got hijacked by the virus.

Serious Health Crisis

I've been working with Chronic Fatigue patients ME and other invisible illnesses. This has been a personal and professional journey for me. And because I find that so many practitioners often struggle to know how to effectively help their patients with prolonged exhaustion, I would like to share a few insights with you.

I see that we're in a serious health crisis, due to the uptick of post viral fatigue, also called ME/CFS, which leads to what I call unnecessary suffering. I believe those who struggle with fatigue, need more strategies for healing and more hope. I would love to guide you to help your patients to experience their full vitality again.

Mitochondria Can Get Hijacked By Virus

I personally believe that when we understand the why, the how becomes much more evident. And just to be super clear, I find that most patients have two to three out of five root causes that lead to their prolonged fatigue.

Mitochondria dysfunction, due to a latent viral infection can be one of the root causes. Now the mistake I've seen most clinicians make is they focus on the one thing. They're thinking that there's one root cause and if we just get rid of this problem, then all will be well.

The truth is that complex illness is well, complex. And when we're talking about mitochondria, they don't live in a vacuum. They're impacted by every aspect of your patient's being ... every aspect of your patient's being. 

I find the best practice is to address the whole person in front of you to be able to open that door to real wellness. With that said, here are some details on one of the coolest things in your body, the mitochondria.

Complex Mechanism

The mitochondria have complex mechanisms to adapt to the dynamics of living in our bodies. Your mitochondria are most well known for cellular respiration, they help us maintain the energy to live.

And we are very, very, very dependent on them. As you know, as a clinician, if they get destroyed in our bodies, we could only live three seconds. This is like the stuff out of comic books. 

Altered Energy Production

Energy production is of course what the mitochondria are the most well known for, most of us learned in high school biology about AT production. And it's truly an amazing system.

It goes on in our cells and it's part of the Krebs cycle. It's like this magical thing where you put two phosphate in and you get three out and all you have to do is add food and water. And it runs all day and all night keeping us alive.

The thing is, the viruses want some of this action, they are known to hijack the host energy pathway, they'll actually alter the cellular respiration for their own survival.

And many of the viruses depend on the host mitochondrial metabolism to generate ATP for them, as well as they use the metabolites of that ATP production for their own viral replication and viral assembly.

The host cell has way less energy. It's kind of like you got high speed internet, and then your neighbors are sucking all your bandwidth away and you can't download a freaking video.

Some viruses can even turn off the mitochondria, so they don't have the Mitophagy; they don't have that self-destruct cycle. And then those viruses can even turn it on again when it suits their need. It's pretty trippy how much these viruses affect the mitochondria.

First Responders to Viral Invasion

The mitochondria are also key to the innate immune system. The second way the mitochondria can be hijacked by a virus is via this system. The mitochondria are often the first responders in a viral invasion.

The mitochondria initiate the innate immune system via interferon signaling. It's been discovered that some viruses such as influenza, measles, and Hep C will impact that mitochondria signaling to reduce interferon, essentially making it so that the mitochondria cannot signal the rest of the immune team to react. And then of course, this allows that virus to live inside that cell undetected.

Fusion and Fission 

The third way the viruses can alter mitochondria function is altering how the mitochondria heal and replicate. One of the ways mitochondria adapt to the stress of living in a dynamic body is through this thing called fission and fusion.

Fusion is a really healthy stress response. It's where the mitochondria take content of two damaged mitochondria coming together to become this elongated mitochondria. It's kind of like having two broken households come together and sharing all the resources, getting rid of the junk that they don't need, and keeping the good stuff so that they can be strong again.

The other thing that mitochondria can do is this thing called fission, where the mitochondria splits into two. This allows the one with the damaged goods to be destroyed through mitophagy and the strong one to survive. Now, viruses can alter this normal function to their benefit.

There are some viruses that will boost fission basically just replicating and replicating and replicating the mitochondria. Getting to divide and divide and divide, divide again, so that the viruses have more places to live and stay, and they block the apoptosis or mitophagy so that the host body cannot stop this process.

Some people theorize that the exhaustion that people get from having viruses in their mitochondria is just from having this fission process going over and over and over again.

Cell Danger Response

The fourth way that the mitochondria can be affected by viruses, and can make the host feel exhausted, is a normal part of mitochondria function called the cell danger response.

This sounds dramatic, and it can be for chronically ill patients. In a healthy cell, the cell danger response (CDR) is a normal reaction to toxic stimuli inside the mitochondria. And there are three phases. 

And when the cycle is complete, the mitochondria returns back to a normal state. The problem is if there's a virus or another noxious stimulus continuously inside the mitochondria, which can easily happen, as you can see with the viruses, because they alter the mitochondria's ability to get rid of the viruses or virus particles.

So the cell danger response never completes its cycle and never gets the all clear sign, it stays in the cell danger response. And this chronic state can alter the metabolism further, by literally slowing down cellular respiration.

It's almost like a hibernation response. And this leads to less energy for the cell, the organ and the body. But it can also further the sense of exhaustion from a bi-directional feedback loop with the brain via the vagus nerve.

Mitochondria Survival

The mitochondria are so integral to the organism's survival. It's not surprising that viruses target the mitochondria as a place to enter and remodel to support their own survival. I personally love to geek out on the mitochondria, I find them fascinating.

They are life itself. And if you're like me, you came into this medicine out of a desire to help people feel better, and a fascination with how the body works. And the miracle that life is.

Unfortunately, at this time, we lack the technology or really good technology anyway, for reliable testing for latent viral infections, as well as really good functioning for mitochondrial function. 

We need to rely on our other training, our training to be able to deduce what ails our patient, through listening through ruling out other probable causes. And remember, this is just one part of why your patient may be feeling exhausted.

Reductionist Thinking

Please don't fall into the trap of reductionist thinking here. If you really, really want to support your patient's full healing, you must see the forest and the whole tree.

How can we as clinicians enter into the struggle for life between the invading virus and the host mitochondria without causing more harm? Now we may come up with a drug to address the mitochondria that has been impacted by a virus.

But honestly, I don't believe we need to wait. We all have many, many tools and strategies right now that we can use to move out latent infections and to allow the patient's body to return to an optimal state of health.

Never Just One Thing

The root cause of your patient's illness is never just one thing. It's a complex interaction of systems. I found in my practice, you can get further faster by addressing these complex chronic conditions from a holistic perspective and use known tools and techniques to get our patients back to full vitality.

RESOURCES:

Gatti, P. (2020). Mitochondria Targeted Viral Replication and Survival Strategies — Prospective on SARS-CoV-2. Frontiers. https://www.frontiersin.org/articles/10.3389/fphar.2020.578599/full

Ohta, A., & Nishiyama, Y. (2011). Mitochondria and viruses. Mitochondrion, 11(1), 1–12. https://doi.org/10.1016/j.mito.2010.08.006

Henderson, T., MD PhD. (2020, June 22). Chronic Fatigue Syndrome, Viruses, and the Innate Immune System. Psychiatry Advisor. https://www.psychiatryadvisor.com/home/topics/general- psychiatry/chronic-fatigue-syndrome-viruses-and-the-innate-immune- system/ 

Ganji, R. (2021). Impact of COVID-19 on Mitochondrial-Based Immunity in Aging and Age-Related Diseases. Frontiers. https://www.frontiersin.org/articles/10.3389/fnagi.2020.614650/full

Perspective: Cell danger response Biology:€The new science that connects environmental health with mitochondria and the rising tide of chronic illness. (2020, March 1). ScienceDirect. https://www.sciencedirect.com/science/article/pii/S1567724919302922

Naviaux, R. K. (n.d.-b). Impact of COVID-19 on Mitochondrial-Based Immunity in Aging and the Cell Danger Response. MDPI. https://doi.org/10.3390/biology8020027

https://naviauxlab.ucsd.edu/wp-content/uploads/2016/09/cell_danger_response.pdf