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Dr. Greg Fors, DC Chronic Pain Expert

Dr. Greg Fors, DC
Chronic Pain Expert
Board-Certified Neurologist
Author of "Why We Hurt"

Dr. Greg Fors has hand selected or developed each of our products based on years of clinical experience treating chronic pain. As a Board Certified Neurologist & expert in chronic pain disorders, Dr. Fors lectures to doctors & therapists around the country on the cause and treatment of myofascial pain & fibromyalgia syndrome.

 
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Why Do I Always Hurt, Feel Depressed And Never Have Any Energy? Or Tuning –Up Your Cellular Engines!

By Dr. Greg Fors, DC, DIBCN
Board-certified Neurologist

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Carol looked across my desk and asked, “Why do I always hurt and feel so tired and depressed?” It's a question that I hear all the time from patients. Like Carol most have been treated with a wide variety of numerous drugs for fibromyalgia, insomnia, hypothyroidism, but most still had their symptoms and many times worse! Looking at Carol's lab work, specifically her urinary organic acid profile, I could see the cause of her problems, like so many other patients she had metabolic problems at the cellular level, specifically mitochondria dysfunction!

What if your muscle cells and brain cells could not produce a vibrant level of cellular energy, called ATP, to handle your active and even stressful lifestyle? How would you feel? Muscle cells without adequate ATP energy become tender, achy and weak. It actually takes more energy or ATP to relax muscle cells than it does to contract them. Therefore when energy is insufficient your muscles become a mass of painful tight knots unable to let go. These knots or myofascial trigger points keep firing into your central nervous system leading to a chronic pain state.

What happens to your brain when you develop a low blood sugar condition, or hypoglycemia? You will commonly experience listless, brain fog, and possibly a headache. Your brain needs a constant supply of glucose and oxygen to continually produce massive amounts of ATP to generate your thoughts and feelings. Your brain is only 2% of your total body weight, but utilizes more than 20% of the available oxygen and 25% of the calories you consume, all for energy production.

Imagine if your muscle cells and neurons were coming up little short in their energy production, or cellular ATP, what sort of symptoms might this bring on? Research is now demonstrating that disorders such as neuropathic pain, migraine headaches, fibromyalgia, depression, anxiety, chronic fatigue and even neurodegeneration all share in common the lack of optimal cellular energy production . Recent research now supports the fact that mitochondrial dysfunction is a primary cause in many mental health disorders, including depression.  A 2009 study found a direct connection between mitochondrial dysfunction and chronic fatigue syndrome.  How can this be?

The Power Plants of Your Cells

At the center of your cells are hundreds of throbbing engines cranking out massive ATP for everything you do, the much unappreciated mitochondria. These organelles have been called the power plants of your cells. They take calories from your food, break it down and literally burn or oxidize it for energy, in a process called cellular respiration. When these little mitochondria are efficiently humming along, like well-tuned engines, you have all the energy you need throughout the day. When your mitochondria are not working efficiently, this can lead to many common problems. Pieczenik and Neustadt recent research found a wide range of unrelated disorders related to mitochondrial dysfunction. They stated in this study that, “Physicians seeking systematic treatments for their patients might consider testing urinary organic acids to determine how best to treat them.”  A test that I find vital for many patient’s recovery!

Just like a car engine will have abnormalities in the exhaust at the tailpipe, if the engine isn't running efficiently, your cells produce metabolites that can be measured in the urine that tells a knowledgeable doctor that your cells engines aren't running efficiently. More than that this test can give a doctor some idea of why your mitochondria are not working efficiently and what is needed to do to fix that. For example, I have found elevation of Adipic acid and Suberic Acid in the urine of patients with fibromyalgia and chronic fatigue. When these urinary metabolic acids are elevated it means that fatty acids are not efficiently being utilized for energy. Elevations of Succinic acid is a marker for a deficiency of CoQ 10 and vitamin B-2 leading to inadequate cellular energy production

Medically it is well recognized that there are specific genetic defects that can render our mitochondria quite dysfunctional manifesting as crippling metabolic diseases. The problem is that our mitochondria are not like a simple on-off switch, either working perfectly or turned off. What is underappreciated by the public and clinicians too is that your mitochondria can decline in their efficiency and lead to many of our most common disorders of today, from chronic muscle pain to depression and even chronic and degenerative diseases.

In fact in a recent 2008 study the prestigious researchers Neustadt and Pieczenik went as far as to state the following: “Damage to mitochondria is now understood to play a role in the pathogenesis (cause) of a wide range of seemingly unrelated disorders such as schizophrenia, bipolar disease, dementia, Alzheimer's disease, epilepsy, migraine headaches, strokes, neuropathic pain, Parkinson's disease, ataxia, transient ischemic attack, cardiomyopathy, coronary artery disease, chronic fatigue syndrome, fibromyalgia, retinitis pigmentosa, diabetes, hepatitis C, and primary biliary cirrhosis. Medications have now emerged as a major cause of mitochondrial damage, which may explain many adverse effects. All classes of psychotropic drugs have been documented to damage mitochondria, as have statin medications, analgesics such as acetaminophen, and many others. ” This means drugs to treat depression and anxiety, or psychotropic drugs, can damage mitochondrial function and decrease cellular energy production

Ready to Face Today’s Metabolic Challenges

The greatest cause of mitochondrial decline is the natural aging process, but certain things can cause this to accelerate and make your cells old before their time. One of the primary ways your mitochondria become inefficient is by depriving them of the necessary nutrients and the proper fuel they need to do their work. With this very common dietary scenario muscle cells can become painful, tender and tired, and the brain becomes sluggish and depressed. Your mitochondria need specific nutrients such as B vitamins, magnesium, zinc and iron to process calories into usable energy or ATP. When you eat a diet filled with empty calories you literally deplete the stores of necessary nutrients your mitochondria need to function properly. This can be diagnosed when specific metabolites are elevated in a urinary organic acid profile.

Even more troubling is that chemicals in our environment have been proven to cause mitochondrial injury and dysfunction. These industrial chemicals and pesticides cause damaging free radicals that disrupt the energy producing process of your mitochondria. This cumulative free radical damage to your cells is called oxidative stress. Elevations of lipid peroxides in the urine are a direct indicator of oxidative damage to your cell membranes and also elevated when tissues are poisoned by chemical toxins. Also elevation of a urinary metabolite called 8-OHdG indicates actual oxidative stress damage to your cellular DNA.

Why does damage to mitochondria lead to so many chronic and degenerative diseases? When the mitochondria become damaged they can actually join the other side and cause damage to surrounding mitochondria and other cell organelles. It is actually the mitochondria that are in charge of whether cells such as your neurons live or die, and if enough damage is done they will signal the cell that it's time to die. This is one way that we lose brain cells over the years until we eventually manifest with Alzheimer's disease or dementia. Therefore, you can see how vital it is to provide your mitochondria with the nutrients they need and to protect them from this damaging effect of chemicals in our environment.

The Cellular 3R Program, Remove/Restore and Repair

How does one go about diagnosing and treating this loss of cellular vitality through mitochondrial decline? This it can be accomplished by a doctor knowledgeable in nutrition and functional medicine through specific laboratory tests utilizing blood, urine and stool, such as the urinary organic acid profile, oxidative stress panel, plasma amino acids and essential fatty acid profile. These are tests that I utilize in my practice to more accurately treat the underlying causes of the wide variety of disorders from fibromyalgia, chronic fatigue and depression to autism and ADHD.

Once the key metabolic factors causing mitochondrial dysfunction have been identified, through proper diagnostic workup, an effective patient specific biomedical program must be commenced to normalize function. Utilizing a 3R program, Remove/Restore and Repair, factors damaging mitochondria must be Removed, based on metabolic needs nutrient levels must be Restored and third cellular and mitochondrial damage must be Repaired. With this 3R program, patients are able to return to a life without pain and depression and without relying on drugs to get them through their day.

Footnotes:

1. Neustadt J, Pieczenik SR, Mol Nutr Food Res. 2008 Jul; 52(7):780-8. Medication-induced mitochondrial damage and disease.
2. Rezin GT, et. Al, Neurochem Res. 2009 Jun;34(6):1021-9. Mitochondrial dysfunction and psychiatric disorders.
3. Myhill S, Booth NE, McLaren-Howard J. Int J Clin Exp Med. 2009; 2(1):1-16Chronic fatigue syndrome and mitochondrial dysfunction.
4. Pieczenik SR, Neustadt JExp Mol Pathol. 2007 Aug; 83(1):84-92. Mitochondrial dysfunction and molecular pathways of disease
5. Neustadt J, Pieczenik SR, Mol Nutr Food Res. 2008 Jul; 52(7):780-8. Medication-induced mitochondrial damage and disease.


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