I was asked this question on the other, less pleasant, platform. Basically: what drugs to I recommend for mitochondrial dysfunction. Here is my response (🧵): 1/
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Hi Marco, what a great question. I'll start by saying that unfortunately it is hard to get drugs approved for improving mitochondrial function because it is so hard often to measure modulations in mitochondrial function in a person. There are supplemental approaches, of course 2/
but many of these supplements haven't necessarily been proven to boost mitochondrial function, but they are able to boost materials that mitochondria need to make energy or reduce oxidative stress. These are supplements like NMN, NAD+, nicotinamide riboside, glutathione, 3/
alpha lipoic acid, vitamin C, CoQ 10, Astaxanthin, Curcumin and many others. However, as I said: we can't guarantee these will boost mitochondrial function or remove reactive oxygen species - that is yet to be proven definitively and that is also hard: genetic and epigenetic 4/
Older coworkers on the road used Nicotinamide riboside, Resversatrol & NAC (Berberine, red yeast rice, Ubiquinol (we'd WORK 84hr weeks, then consume >2,500 calories @ Asian, Indian buffets; usually with hoppy ale) no HFCS; but TOO many carbs. Past retirement when D614G hit (C, Quercetin, D3, krill).
variations in ppl can influence how they respond to these supplements, as can their gut health: dysbiosis and leaky gut can mean that if you ingest any of these, they do not work, which is why some folks have not responded at all to ingesting supplements, but have responded 5/
strongly to the same compounds in patch or IV form. There is also the issue of dosage - we're not sure how to dose these things in disease states vs. health states. We have some clinical trial data to guide us in some disease states, but it is honestly patchy right now and we 6/
need to learn more. When it comes to drugs, here are my 3 picks that urgently need clinical trials:
1) low dose rapamycin: inhibiting the mTOR pathway can activate AMPK and PGC-1a which promote the creation of new mitochondria. It also supports mitophagy to help removal of 7/
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1) low dose rapamycin: inhibiting the mTOR pathway can activate AMPK and PGC-1a which promote the creation of new mitochondria. It also supports mitophagy to help removal of 7/