Alex:  Hi, I’m Alex Howard, and I’m here with Tanya Page, one of the nutrition team at the clinic, and today we’re going to be talking about mitochondrial function and their role in M.E, Chronic Fatigue, Fibromyalgia and really that group of illnesses.  And I think this is one of the most fascinating areas of what we as a clinic have really been quite trailblazing in, in the last 3, 4 years or so, because what it explains from our CFS and ME research… one of the things it explains is the delayed fatigue response that a lot of patients experience.  And when I look back on my own experience of being ill, that was so difficult to understand that I could be fine for a few days, maybe overdo it a little bit, but I’d have no reaction, and then a couple of days later it was like someone had pulled the plug of energy and I just felt completely awful, and of course this really explains the process.  So Tanya, maybe a good starting point is what the mitochondria actually are and that will lead us on to the CFS and ME research in more detail.

Tanya:  Ok, well they’re basically the little energy producing parts of every cell, so pretty much every cell has mitochondria and they’re whole… well they do a few other things apart from it, but the main function is to produce energy, and without that, you can’t do any ‘enzymic’ metabolic reactions in the body, nothing works.  Everything in the body is driven by ATP.

Alex:  Ok, ok.  And that being a case of what they are, how is it relevant with M.E and so how people actually get symptoms as a result of this process not working?

Tanya:  Ok, the easiest way to describe that is to use a visual aid.  Normally, I’d draw a diagram for a patient, but in this case we’re going to use balls.  [Picking up a large fist-sized yellow ball and a smaller pink ball]

Alex:   [Laughing]  And I should comment that when Tanya made a request to the office for ping-pong balls and a tennis ball, I got very excited because the ping-pong ball actually came with bats as well, so we now basically have table tennis in our office on one of the desks, but obviously more importantly today is explaining mitochondrial function and its role in the CFS and ME research.

Tanya:  Indeed, indeed, because ATP is when you start talking technical about ATP, people’s eyes glaze over a little bit, so just to use the visual aids to make it easier to understand, so we do actually have to talk about the structure of the molecule of ATP to make sense.  So this is Adenosine, ok, [holding up the yellow tennis ball] this is just a nucleotide.  This is Ribose, it’s a sugar, [holding up the pink smaller ball] and that together, [joining the pink ball on top of the tennis ball] forms Adenosine, ok.  And then we have some Phosphate molecules, [putting another pink ball on top of the pink ball already there slightly to the right] and there’s 3 of those, [placing another pink ball on top of the first pink ball slightly to the left] if I can extract my hair from them, [placing the 3^rd pink ball between the other 2 balls at the back of the first pink ball] and that becomes adenosine triphosphate, 3 molecules, so hopefully you can see that ok.  So adenosine here, [pointing to first pink ball] and then triphosphate, [pointing to three surrounding pink balls] ok?  That’s important because in order to create energy, you need to lose a phosphate molecule, [pulling one of the 3 pink balls away from the first pink ball] from ATP and it becomes ADP, Adenosine triphosphate.  So in order to produce energy, this has to be released, [holding the removed pink ball] and Alex is going to show…

Alex:  [Tanya throws the pink ball to Alex who hits it towards the camera with the ping-pong bat]

Charlie:  [Camera person] Ow!

Alex:  Nearly hit the camera person.  [Laughing] I’ll get another go in a second.

Tanya:  Energy being released, ok.  So what’s important in CFS and ME research and in the body, normally you should have a recycling process, but once you’ve lost a phosphate molecule from ATP, you need to get it back to recycle it back to ATP, so back… back mysteriously comes that phosphate molecule.  [Attaching 3^rd pink ball onto 1^st ball again]  So there you’ve got ATP again.  So apparently you actually get through your own weight in ATP molecules a day; that’s what you’re supposed to do, ok, but obviously some of our patients are not producing that much, so again, you lose a phosphate molecule to produce… [taking off the pink ball again and throwing to Alex who hits it again with the ping-pong bat]

Alex:  Ooh, I just hit the camera person in the face, sorry Charlie.  [Laughing]  I’m not too good shot.  There’s mass resignations this afternoon.  It’s on the floor over there.  [Pointing to the ping-pong ball]

Tanya:  Don’t worry, don’t worry.  [Talking to the camera person]  It’s ok, because we’re left now with ADP, adenosine diphosphate.  So obviously what we’ve just been demonstrating is what should happen.  From the CFS and ME research what can happen is if you haven’t got the raw materials, if you haven’t got some of the background stuff or the metabolic ability to keep producing ATP on a regular basis, from the chemicals engineered from your food, you’ll be left a bit more often with ADP, and if you can’t actually recycle that 3^rd phosphate molecule, you’re going to have to start breaking this down, so you’d again lose… [removing another pink ball from the first pink ball and throwing to Alex]

Alex:  I would duck this time.  [Hitting the pink ball] It hit the camera.  [Cheering]

Tanya:  So then we’re left with AMP, adenosine monophosphate.  Now unfortunately this can’t be made back into ATP, so we can’t get any energy from this, so the only option we’ve got is to go back to the first principles and make the whole from raw materials again, which can take several days.  So what Alex was talking about earlier in that you overexert yourself perhaps, do a little bit extra physical or mental work, you can get yourself into a situation where you’re just… your resources are just being lost gradually until you’re finally left with no ability to make ATP.  At that point, you hit the wall, because you can’t produce anymore energy.

Alex:  And from the CFS and ME research, that’s when you feel like you’re crashing because you’ve lost your energy?

Tanya:  Exactly, exactly, and interestingly it’s exactly the same experience that marathon runners get when they hit the wall, it’s exactly the same; they run out of ATP.

Alex:  And  of course they have adrenal reserves and that kind of thing they can then use in that situation.

Tanya:  Yeah, absolutely, but in a Chronic Fatigue patient, they’re going to have to rest for 3 days maybe until the raw materials can come in.

Alex:  And of course they start coming back, [putting another pink ball on the 1^st one] and there’s one on the floor, [getting up to get ball on floor and also putting it on the 1^st pink ball]…

Tanya:  Very good.  And you’ve got your ATP again.  So as long as that recycling happens, everything’s fine.  From the CFS and ME research, if it starts to go wrong, that explains why you get that ‘urgh’ feeling; it’s you losing your balls basically.

Alex:  [Laughing]  So that being the process of what happens in the body, how do we test for that?

Tanya:  We test using a blood test which looks at how much ATP you’re actually producing which is really important; have you got the raw materials to make ATP in the mitochondria, 2^nd are you able to do that recycling process and there’s several things to look at to find out whether you’re recycling effectively.  One of the things that can be… it’s not that common, but sometimes it’s the energy cycle being where energy is passed out of the mitochondria to the rest of the cell, that can actually become blocked and that can be through heavy metals, pesticides, and various imbalances in the cells.

Alex:  And these things of course come up in the blood test that we can see if these are around, yeah?

Tanya:  Absolutely, so we know exactly what’s going on, whether its raw materials which we can give you via supplementation or whether it’s blockages we have to sort out through treating heavy metals or pesticides or other chemicals.

Alex:  So then in terms of finding out what’s going on and from the CFS and ME research, what can we do about it, which I guess is the final piece?

Tanya:  Yeah, well once we know what the situation is, you either have to supplement with the raw materials, or start detoxing if it’s something blocking the energy cycle, but essentially, it’s fairly straight forward to put the bits in that you’re missing and slowly build up the ability to actually create that healthy recycling again.

Alex:  So it’s almost like you’re supporting your system in the short-term, so it can then do that for itself in the long-term?

Tanya:  Absolutely.  Once it’s going, it can stay going, it’s just once you put that spanner in the works and the whole thing falls down, then you’re fine, so pacing is really important, so the psychology team are really important in helping our patients to actually stay within the limits, bounce the boundaries just gently, because once you lose your balls basically, you’ve got to start again, and then it’s a lot of energy to build it back up again, so what we like to do is to give you all the nutrients you need to be able to recycle and keep yourself there.

Alex:  And of course, you know, we’re kind of running out of time for this video, but it’s also very much linked in on the psychology side to those energy depleting psychologies like the achiever type and the helper type, where someone’s always pushing beyond what they’re able to do, and then as a result they keep putting stress on their mitochondria.  So in terms of the psychology side, working through those patterns, and then getting on their biomedical side, getting the nutrients then if it’s appropriate to then support the system in replenishing itself.

Tanya:  Indeed.

Alex:  So with the CFS and ME research, this is a very complex area, and it’s something that you know, it’s not appropriate for someone at home just to kind of… I know… we’ve come across patients that have just started buying mitochondria supplements, but it really does need the depth of testing first to find out what’s going on.

Tanya:  Indeed, and then putting the appropriate nutrients in at the right time.

Alex:  Based on what’s happening, yeah.

Tanya:  Yeah.

Alex:  Yeah, ok, great.  Well thank you for watching, thank you Tania.  Hopefully that’s been helpful for people.  And if you want to investigate more, obviously 15 minute chats are a great way of doing that.  And I’ll have a final shot at the camera, [taking a pink ball again] so Charlie might want to duck behind.  [Hits ball]  Argh. Another one.  [Takes another one and hits it] [Shakes head as takes another one]  I’m going to give up in a second.  [Hits another one]  They’re now coming back this way.  [Hits another one]  Thanks for watching, talk to you again soon.