Energy: Optimal Levels

Prime Your Body’s Cells for Optimal Energy

Tired? Run down? Burned out? Worn out? Exhausted?  One of every four people admits to feeling tired much of the time. And a recent survey, conducted by the Hartman Group, which tracks consumer trends, found that one-third of Americans say they have less energy today compared with a year ago. Not surprisingly, fatigue is the most common complaint physicians hear from their patients.

There are a great many reasons why so many people feel tired. Sometimes it’s a lack of restful sleep. Other times we just push ourselves too hard at home and work. Poor eating habits play a big role in feeling tired. And often people don’t eat enough of the right kind of energy nutrients.

Sugar and Caffeine—Energy-Draining Foods

Most of us were taught as children that sugary foods are “energy foods,” and many people end up over-eating them in the pursuit of higher energy levels. But eating too many sugary foods or refined sugar-like carbs (e.g., breads, muffins, pasta) actually has a boomerang effect, so we end up feeling tired and lethargic.

What accounts for the anti-energy effect of sugar? Sugar and sugar-like carbs raise blood glucose levels very quickly and very high, which shuts down production of orexins, a family of brain peptides responsible for keeping our minds sharp.[1] The high blood glucose levels also trigger a system inflammatory response. Together, lower orexins and higher inflammation leave us mentally fuzzy and physically tired.

Many people compensate by consuming caffeine, such as in coffee, soft drinks, or energy drinks. Caffeine might provide a brief burst of energy, but it also leads to rebound fatigue. In one study, British researchers found that consuming a popular energy drink (containing 30 mg of caffeine and 42 grams of sugars) slowed reaction times and led to greater sleepiness![2]

Two recent reports in the International Journal of Clinical Practice pointed to yet another cause of fatigue. Cola soft drinks, with their combination of sugars and caffeine, deplete levels of potassium, a mineral needed for normal muscle function. The result? Severe muscle weakness and fatigue. Doctors reported that patients recovered after they stopped consuming soft drinks, although some needed potassium supplements. Fatigue was most often related to the consumption of three or more quarts of soft drinks daily. [3] [4] But the regular consumption of smaller amounts of colas likely impacts potassium levels as well.

Real Energy Foods

One of the keys to good energy levels is maintaining relatively stable blood sugar levels. The best way of accomplishing this is by eating quality proteins, such as chicken and fish, and high-fiber vegetables. The protein and fiber stabilize blood sugar, thereby avoiding the peaks and valleys triggered by sugar and carb-rich foods.

Both animal and vegetable proteins have other benefits that can enhance energy levels. Muscle consists of protein, and you need to consume protein to make muscle. (Of course, most people also need regular exercise to make muscle.) Several recent studies have shown that eating more protein or taking amino acid supplements increase muscle in seniors, even without exercise. [5] [6] Multi amino acid supplements are a great way for vegetarians to boost their protein intake.

Muscle meats, such as beef and lamb, are also very dense in mitochondria, microscopic cell structures that break down food for energy. While our bodies cannot use these mitochondria per se, we can use the nutrients (e.g., L-carnitine and coenzyme Q10) they contain to support our own mitochondria and energy-generating cell activities.

Green leafy vegetables, such as dark lettuce, spinach, and kale, contain chloroplasts, the plants’ equivalent of mitochondria. Chloroplasts convert the energy of sunlight into specific energy-generating compounds, such as the B-complex vitamins. So eating vegetables also helps feed our own mitochondria.

How Cells Make Energy for You

The energy you need to do everything you want in life comes from the collective efforts of the 70 trillion cells in your body. Each cell contains anywhere from one to thousands of mitochondria. The most energetic tissues—the heart and other muscles, liver, and brain—contain the most mitochondria.

Known as bioenergetics, the production of cellular energy involves three key biochemical processes: glycolysis, the Krebs cycle, and oxidative phosphorylation. Everything in these processes leads to increased production of the chemical form of energy, known as adenosine triphosphate (ATP).

Nutrients provide the chemical foundation of bioenergetics. During digestion, carbohydrates are broken down to glucose, a simple sugar. During glycolysis, glucose gets converted to pyruvate, an intermediate energy-generating compound. This conversion depends on alpha-lipoic acid (an antioxidant) and vitamin B1. Pyruvate then enters the Krebs cycle, and chemical reactions immediately begin using it to create ATP. Meanwhile, L-carnitine helps transport fats into the Krebs cycle, where they too are burned for energy. Your body makes L-carnitine, but needs vitamin C to do so. Low intake of either L-carnitine or vitamin C will interfere with the conversion of fat to energy.

Vitamin B1 functions as the “throttle” that sets the Krebs cycle in motion. Much of the Krebs cycle revolves around two other compounds built around B vitamins: nicotinamide adenine dinucleotide (NAD) depends on vitamin B3, and flavin adenine dinucleotide (FAD) depends on vitamin B2. Both NAD and FAD help make ATP. The body needs alpha-lipoic acid in the Krebs cycle also, where it serves as a cofactor for the important enzyme alpha-ketoglutarate dehydrogenase.

Much of the ATP generated by the Krebs cycle enters the final biochemical pathway, oxidative phosphorylation. Coenzyme Q10 (CoQ10), a vitamin-like nutrient, plays a key role here in furthering the production of energy in the form of ATP. CoQ10 has a remarkable pedigree—it was the basis of the 1978 Nobel Prize in chemistry, awarded to the late Peter Mitchell, PhD, of England.

Another nutrient, ribose, is an important building block of ATP. Ribose is technically a carbohydrate, and it forms part of the chemical backbone of many important compounds, including DNA and RNA. To make ATP and to recycle and reuse it, your cells need adequate amounts of chemicals called adenine nucleotides. These adenine nucleotides depend on the presence of ribose.

How to Take Mitochondrial Nutrients

I often refer to the vitamins and vitamin-like nutrients involved in glycolysis, the Krebs cycle, and oxidative phosphorylation, as mitochondrial nutrients. I often recommend these nutrients (in conjunction with healthier eating habits and greater physical activity) to people with low energy levels. These nutrients enhance the body’s ability to breakdown and process food molecules for energy.

B-complex vitamins

As a group, these nutrients play diverse roles in health. Instead of recommending only the handful of B vitamins involved in glycolysis and the Krebs cycle, I encourage people to take all 11 B-complex vitamins in the form of a high-potency multivitamin.

My recommendation: Look for a high-potency multivitamin (or B-complex) supplement at a natural foods store. Pick one with at least 50 mg each of vitamins B1, B2, and B3. As a general rule, if these three vitamins are of sufficient potency, the others in the formula will be in relative potencies.

Alpha-lipoic acid

Although alpha-lipoic acid is widely taken as an antioxidant supplement, it also enhances Krebs cycle activity and ATP production. Alpha-lipoic acid has the added benefit of improving insulin function, which in turn helps regulate blood glucose levels.[7] [8] Italian doctors described the case of a 33-year-old woman who, since childhood, had been thin, weak, and intolerant of exercise. By her 30s, she had very weak arm and leg muscles. Tests showed that her body was making very low levels of ATP. She was given 200 mg of alpha-lipoic acid three times daily, and after several months her ATP production had increased and her symptoms improved substantially.[9]

My recommendation: Consider taking 200 to 400 mg of alpha-lipoic acid in combination with B-complex vitamins or L-carnitine.


L-carnitine supplements boost energy by enabling cells to do a better job of burning fats. Human studies have shown that carnitine supplements increase energy levels in people with chronic fatigue syndrome, multiple sclerosis, and cancer. In animal studies, Bruce N. Ames, PhD, of the University of California, Berkeley, showed that a combination of alpha-lipoic acid and acetyl-L-carnitine (a form of L-carnitine) increased both physical and mental energy levels. Old laboratory rats functioned essentially like that of young animals. According to the researchers, the effect was comparable to a 75-year-old person gaining the vigor of someone half his age.[10]

My recommendation: Consider taking 1,000 to 3,000 mg (1 to 3 grams) of either L-carnitine or acetyl-L-carnitine daily. You’re likely to gain greater benefits by taking it with alpha-lipoic acid or 1,000 mg (or more) of vitamin C.

Coenzyme Q10

Japanese cardiologists began using CoQ10 to treat cardiomyopathy and heart failure—diseases characterized by a lack of energy in heart tissue—in the 1960s. The first U.S. clinical trials were performed in the 1980s, and more recent reports show impressive cardiovascular benefits.[11] [12] Recent investigations have found that large amounts of CoQ10 can slow the progression of Parkinson’s disease, presumably by increasing energy production in the brain.[13] Still other studies suggest that CoQ10 might help boost immune cell activity to fight cancer and viral infections.

It is particularly important that you supplement with CoQ10 if you take a cholesterol-lowering statin drug (e.g., Lipitor). Statins work by choking off an enzyme, HMG-Coenzyme A, which is needed to make both cholesterol and CoQ10.

My recommendation: Whether or not you take statins, you will benefit from taking 100 mg of CoQ10 daily. People with cardiomyopathy or heart failure will probably need 300 to 400 mg daily. Because CoQ10 will improve heart function, requirements for other medications will likely decrease. Please work with your physician in this situation.


Athletes often take supplemental ribose to boost their stamina and strength. In doing so, they increase their mitochondrial activity and fuel reserves for their cells. A study of male bodybuilders at the University of Nebraska, Kearny, found that taking supplemental ribose (10 grams daily) for several weeks led to increases in stamina and bench-press strength, compared with men taking placebos.[14] Other studies have found that ribose supplements provide some benefits in heart failure.

My recommendation: To boost energy levels, I suggest taking 1,000 to 2,000 mg of ribose daily. Serious athletes may benefit from as much as 10 grams daily.

By following a healthy diet and taking some of the key mitochondrial nutrients, you’ll be able to avoid your own personal energy crisis.


[1] Burdakov D, Lensen LT, Alexopoulos H, et al. Tandem-pore K+ chanels mediate inhibition of orexin neurons by glucose. Neuron, 2006;50:711-722.

[2] Anderson C, Horne JA. A high sugar content, low caffeine drink does not alleviate sleepiness but may worsen it. Human Psychopharmacology, 2006;21:299-303.

[3] Tsimihodimos V, Kakaidi V, Eilisaf M. Cola-induced hypokalaemia: pathophysiological mechanisms and clinical implications. International Journal of Clinical Practice, 2009; 63:900-902

[4] Packer CD. Cola-induced hypokalaemia: a super-sized problem. International Journal of Clinical Practice, 2009; 63:833-835.

[5] Solerte SB, Gazzaruso C, Bonacasa R, et al. Nutritional supplements with oral amino acid mixtures increases whole-body lean mass and insulin sensitivity in elderly subjects with sarcopenia. American Journal of Cardiology, 2008; 101[suppl]69E-77E.

[6] Borsheim E, Bui QUT, Tissier S, et al. Effect of amino acid supplementation on muscle mass, strength and physical function in elderly. Clinical Nutrition, 2008; 27(2):189-95.

[7] Singh U, Jialal I. Alpha-lipoic acid supplementation and diabetes. Nutrition Reviews, 2008;66:646-657.

[8] Jacob S, Henriksen EJ, Schiemann AL, et al. Enhancement of glucose disposal in patients with type 2 diabetes by alpha-lipoic acid. Arzneimittel-Forschung, 1995;45:872-874.

[9] Barbiroli B, Medori R, Tritschler HJ, et al. Lipoic (thioctic) acid increases brain energy availability and skeletal muscle performance as shown by in vivo 31P-MRS in a patient with mitochondrial cytopathy. Journal of Neurology, 1995;242:472-477.

[10] Liu J, Killilea DW, Ames BN. Age-associated mitochondrial oxidative decay: improvement of carnitine acetyltransferase substrate-binding affinity and activity in brain by feeding old rats acetyl-L-carnitine and/or R-a-lipoic acid. Proceedings of the National Academy of Sciences of the USA, 2002;99:1876-1881.

[11] Singh U, Devaraj S, Jialal I. Coenzyme Q10 supplementation and heart failure. Nutrition Reviews, 2007;65(6 Pt 1):286-293.

[12] Pepe S, Marasco SF, Haas SJ, et al. Coenzyme Q10 in cardiovascular disease. Mitochondrion, 2007;7 Suppl:S154-S167

[13] Shults CW, Oakes D, Kieburtz K, et al. Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. Archives of Neurology, 2002;59:1541-1545.

[14] Van Gammerren D, Falk D, Antonio J. The effects of four weeks of ribose supplementation on body composition and exercise performance in healthy, young, male recreational bodybuilders: a double-blind, placebo-controlled trial. Current Therapeutic Research—Clinical and Experimental, 2002;63:486-495.


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