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Why Chronic Pain Causes Fatigue

Chronic pain and fatigue go hand in hand, and there is a very good reason for this. It's not because of a lack of sleep, stress, medications, of a lack of exercise, or any of the other common beliefs. Although these can all contribute to chronic fatigue, there is something much more prevalent at the root of these two conditions.

Mitochondrial Dysfunction

If you don't remember your mitochondria from school science class, they are the powerhouse of your cell! They are tiny organelles, found in almost every cell in your body, that produce ATP (energy). Without ATP we wouldn't be able to do anything. It is the fuel your body uses to to carry out every function from beating your heart, to thinking, to moving your body.

Mitochondrial dysfunction is one of those things that nobody really thinks about because nobody realizes they have it. We all produce enough energy to survive and get through the day so clearly our mitochondria are working right? Not exactly...

How do our mitochondria produce energy?

The very short answer is that mitochondria take nutrients from the food we eat, mix it with the oxygen we breath, and create ATP. Mitochondria have a preference for what food you eat, though. They love fat! For every molecule of fat you consume, your mitochondria will produce 129 ATP. Not a bad output compared to 38 ATP for every molecule of glucose you consume.

Seems like a simple process, what could possibly go wrong?

There is no perfect system in the body. For every good an organelle, organ, or system does, there is some degree of bad waste product produced. While producing ATP, your mitochondria also produce free radicals. Tiny molecules that bounce around your body and cause destruction to your body tissues. This is the reason why we consume anti-oxidants if you didn't know. They help neutralize free radicals.

If we consume a diet high in sugar and carbohydrates, more free radicals will form and less ATP is produced. If we are experiencing oxygen deprivation (which you can experience without feeling like you are out of breath), your mitochondria will also start to produce more free radicals and lactic acid, the chemical that is responsible for sore and achy muscles after exercise.

Who has mitochondrial dysfunction?

A lot of people actually. You wouldn't think so because it is not a commonly talked about condition but every chronic pain sufferer has some degree of mitochondrial dysfunction. This dysfunction leads to chronic fatigue because you are no longer producing adequate amounts of ATP and now you are producing a lot of other harmful byproducts like free radicals and lactic acid that zap your energy.

If you're experiencing mitochondrial dysfunction you probably don't even realize it, nor does your doctor. You have enough energy to get through the day but there is not enough left over to heal damaged tissues, or to allow you to feel refreshed and energized. If you are experiencing sore and achy muscles and joints without exercise, this is a tell tale sign that you have mitochondrial dysfunction.

There are no specific tests for mitochondrial dysfunction so doctors don't even look for it. There are no medications that can treat mitochondrial dysfunction, so your doctors aren't even talking about it.

How do you develop mitochondrial dysfunction?

The number one way someone developed mitochondrial dysfunction is by not supplying your mitochondria with enough food or oxygen. Diets high in carbohydrates and sugar, and low in fat lead to a low production of ATP and a high production of free radicals and lactic acid which destroy your mitochondria, leaving you with less to make ATP. Low levels of oxygen produce the same results. A sedentary lifestyle is most to blame for this, in combination with pulmonary diseases like COPD. If you are not getting adequate movement per day you are not raising your heart rate which is necessary to deliver more oxygen to all of your mitochondria throughout your entire body.

Toxins such as alcohol, BPA (found in plastics), phthalates (found in personal care products), pesticides and herbicides, and food colorings in food cause mitochondrial dysfunction. Not to mention the long list of medications that contribute to mitochondrial dysfunction like corticosteroids, aspirin, Tylenol, anxiolytics, antibiotics, antidepressants, cholesterol medications, diabetes medications, and cardiovascular medications to name a few of the more common ones.

Your mitochondria are complex organelles that require a lot of different nutrients to function optimally. Diets low in certain nutrients, listed below, leaves your mitochondria without the tools they need to do their job.

What can be done about it?

The first thing is making simple improvements your diet. Eating a whole food diet will supply your mitochondria with the nutrients it needs to make ATP. Increase the amount of health fats you consume, decrease the amount of sugar and carbohydrates you consume, and get as much movement as you can to increase the amount of oxygen delivered to your mitochondria.

Talk to your doctor about any medications you are on and if they contribute to mitochondrial dysfunction (your doctor may not even know that this is a possible side effect so be prepared to have that discussion).

Supplement with vital nutrients to increase energy production and decrease free radical production like:

  • D-ribose

  • PQQ

  • CoQ10

  • L-carnitine

  • Magnesium glycinate

  • ALA

  • Glutathione

  • Fish oil


Treating mitochondria dysfunction is a necessity for anyone suffering from chronic pain and/or fatigue. It is the most common denominator between the two and can easily be treated on your own with some time and effort.

If you want to learn even more about mitochondrial dysfunction and how to treat it you can watch a webinar I gave with the US Pain Foundation on the topic here.

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