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Mitochondrial Assessment & Support

2025-11-05 Mitochondrial Assessment & Support

Below is our Mitochondrial Function Assesment that you can take at home to see if you may have a higher risk of mitochondrial dysfunction. Below that are some tips and tricks for improving mitochondrial health and function.

Mitochondrial Function

Symptom-Based

Assessment Tool

Disclaimer: This tool is a screening guide and not diagnostic. Consult a healthcare professional for evaluation.

Are you taking any hormone therapy? This can include hormonal birth control, post-menopausal hormone therapy, testosterone therapy for men with “Low T”, or gender-affirming care.

No Yes If yes, what medication?

Why do we ask this?

Estrogen increases mitochondrial biogenesis, stabilizes mitochondrial membrane potential, increases antioxidant defenses, and promotes ATP production. Post-menopausal women on hormonal replacement may experience improvements or a lack of reduction of mitochondrial function. Transfeminine individuals on estrogen may experience improved mitochondrial resilience in some contexts, especially if starting from a testosterone-dominant baseline.

Testosterone increases muscle mitochondrial content and oxidative phosphorylation efficiency. However, in excess or aromatized to estradiol, it may shift the redox balance or promote oxidative stress in some tissues. Men on testosterone therapy may have detrimental increases in their redox balance if the level exceeds the normal range. Transmasculine individuals on testosterone may experience mitochondrial stimulation, especially in muscle and energy-demanding tissues- but side effects depend on dose and tissue-specific conversion.

Race:

If strong ancestral ties to a certain geographic region (i.e. grandparents immigrated from Italy) what location:

Have any blood relatives been diagnosed with mitochondrial disease/disorders:

No Yes If yes, what relation are they to you and what is their diagnosis?

Medical History

Metabolic Disease

  • Diabetes
  • Obesity

Autoimmune Conditions

  • Systemic Lupus Erythematosus
  • Type 1 diabetes
  • Rheumatoid Arthritis
  • Hashimoto’s Thyroiditis
  • Graves’ DIsease
  • Sjogren’s Syndrome
  • Autoimmune Hepatitis
  • Primary Biliary Cholangitis
  • Celiac Disease
  • Other __________________

Neurodegenerative Disease

  • Alzheimer’s Disease
  • Parkinson’s Disease
  • Amyotrophic lateral sclerosis
  • Multiple Sclerosis
  • Huntington’s Disease
  • Myasthenia Gravis

Mitochondrial Indicators

  • Seizures/ Epilepsy
  • Fibromyalgia
  • Chronic Fatigue Syndrome
  • Chronic Pain Syndrome

Symptom Assessment

Rate each symptom over the past 6 months

(0 = Never, 1 = Mild/Rare, 2 = Moderate/Occasional, 3 = Severe/Frequent)

Energy and Fatigue
Unexplained fatigue, even after rest
Prolonged recovery after illness/exertion
Exercise intolerance (tiring quickly compared to peers)
Muscular System
Muscle weakness (e.g., difficulty climbing stairs)
Muscle pain/cramps without exertion
Ptosis (drooping eyelids) or ophthalmoplegia (eye movement issues)
Muscles that fatigue quickly but get better (even if just a small bit) after rest
Neurological Symptoms
Migraines/severe headaches
Balance/coordination issues or ataxia
Developmental delays (in children) or cognitive decline (adults)
Metabolic & Systemic
Heat/cold intolerance
Hypoglycemia symptoms (shaking, sweating)
Unexplained weight loss/growth failure (children)
Gastrointestinal
Swallowing difficulties (dysphagia) or reflux
Chronic constipation/diarrhea
Vomiting/nausea unrelated to illness
Cardiac
Arrhythmias (palpitations, dizziness)
History of cardiomyopathy
Sensory
Vision loss/hearing impairment (unrelated to age)
Other
Recurrent metabolic crises (e.g., lactic acidosis)

Scoring & Interpretation

Total Score: Sum all responses.

0–15: Low likelihood of mitochondrial dysfunction.

16–30: Moderate likelihood; consider specialist consultation.

31+: High likelihood; urgent evaluation recommended.

Recommendations

Low Score: Monitor symptoms; reassess if changes occur.

Moderate/High Score: Consult a neurologist, geneticist, or metabolic specialist.

Diagnostic Steps: Blood tests (lactate, pyruvate), genetic testing, muscle biopsy, or imaging.

Tips and Tricks to Improve Mitochondrial Function

Foods that Support Mitochondrial Function

  • Fatty fish (salmon, sardines, mackerel): rich in omega-3s (DHA/EPA) which improve mitochondrial membrane fluidity.
  • Leafy greens (spinach, kale): high in magnesium, needed for ATP production.
  • Nuts & seeds (walnuts, flax, chia, pumpkin seeds): sources of omega-3s, CoQ10 precursors, and minerals.
  • Berries (blueberries, raspberries, blackberries): polyphenols (resveratrol, anthocyanins) stimulate mitochondrial biogenesis via SIRT1/AMPK/PGC-1α.
  • Green tea: EGCG supports mitochondrial protection and biogenesis.
  • Olive oil & avocados: monounsaturated fats and polyphenols protect mitochondria.
  • Cruciferous vegetables (broccoli, Brussels sprouts, cauliflower): sulforaphane enhances NRF2 signaling, antioxidant defense, and mitochondrial quality control.

Supplements for Mitochondrial Function

  • Coenzyme Q10 (Ubiquinone/Ubiquinol): electron transport chain support.
  • Nicotinamide riboside (NR) or Nicotinamide mononucleotide (NMN): increase NAD+, boosting SIRT1 and PGC-1α signaling.
  • Alpha-lipoic acid: antioxidant and cofactor in mitochondrial enzyme complexes.
  • Acetyl-L-carnitine (ALCAR): improves fatty acid transport into mitochondria.
  • Creatine: buffers ATP demand.
  • Magnesium: essential for ATP binding.
  • PQQ (Pyrroloquinoline quinone): stimulates mitochondrial biogenesis.
  • D-ribose: helps replenish ATP pool.
  • Curcumin: activates NRF2 and AMPK.
  • Resveratrol & quercetin: polyphenols that activate SIRT1, AMPK, and PGC-1α.

Lifestyle Changes that Promote Biogenesis

  • Exercise (especially HIIT and endurance training): increases mitochondrial density via AMPK and PGC-1α pathways.
  • Cold exposure (cryotherapy, cold showers): activates brown fat and mitochondrial uncoupling proteins.
  • Intermittent fasting / caloric restriction: increases NAD+, AMPK activation, and autophagy.
  • Adequate sleep: restores mitochondrial turnover and antioxidant capacity.
  • Sunlight (UV & infrared exposure): infrared light stimulates cytochrome c oxidase and ATP production.
  • Breathwork & oxygen optimization: enhances mitochondrial oxygen utilization.

Herbs and Botanicals

  • Rhodiola rosea: improves ATP production and fatigue resistance.
  • Ginseng (Panax ginseng): ginsenosides enhance mitochondrial efficiency.
  • Ashwagandha: adaptogen that supports mitochondrial antioxidant defense.
  • Cordyceps mushroom: increases ATP production and oxygen utilization.
  • Ginkgo biloba: enhances blood flow and mitochondrial efficiency in neurons.
  • Schisandra chinensis: promotes mitochondrial protection and endurance.
  • Milk thistle (silymarin): protects mitochondria in liver cells.

Medications (some under research/off-label use)

  • Metformin: activates AMPK, indirectly promoting mitochondrial biogenesis.
  • AICAR (AMPK activator, research drug): mimics exercise by activating AMPK.
  • Bezafibrate (fibrate drug): activates PPARs and PGC-1α, increasing mitochondrial number.
  • Rapamycin (mTOR inhibitor, research/anti-aging studies): promotes autophagy and mitochondrial quality control.
  • EPO (erythropoietin, in certain conditions): may stimulate mitochondrial biogenesis.
  • Melatonin: mitochondrial antioxidant, improves efficiency.
  • Thyroid hormone (T3/T4): strongly stimulates mitochondrial biogenesis (but must be balanced).