Interview by Craig Gustafson
Jon Kaiser, MD, has treated patients with chronic fatigue syndrome, HIV/AIDS, cancer, and other immune system disorders for the past 25 years. To that end, he strives to help patients and health care providers treat complex medical conditions utilizing an integration of natural and standard medical treatments.
He is a clinical instructor in the Department of Medicine at the University of California San Francisco Medical School and medical director of K-PAX Pharmaceuticals.
Dr Kaiser was the principle investigator of a 2006 study published in the Journal of AIDS,1 showing that broad-spectrum micronutrient therapy can strengthen the immune systems of people with immune deficiency disorders. He is currently coordinating the development of a new treatment for chronic fatigue syndrome that is based on enhancing mitochondrial energy production. The second of 2 clinical trials investigating this treatment is scheduled to complete in mid-2015. He has written 2 books on improving immune system health: Immune Power2 and Healing HIV.3 (Altern Ther Health Med. 2015;21(suppl 2):77-79.)
Alternative Therapies in Health and Medicine (ATHM): Could you begin with a quick overview of what mitochondria are and what role they play in the cell?
Dr Kaiser: The mitochondria are believed to have been independent organisms several billion years ago that ultimately were ingested by larger organisms. Instead of digesting them, those larger organisms decided that they might actually be good to incorporate and benefit from their ability to do 2 things. One is to utilize oxygen in the environment, which before the evolution of mitochondria was toxic to cells. The other is to produce surplus adenosine triphosphate, or ATP—a trait that was very useful to those early cells. A symbiotic relationship developed between those cells and the mitochondria.
Fast forward several billion years: One of the reasons we were able to develop as complex multisystem organisms is due to the abundant energy supplied to our cells by the mitochondria. Essentially, what the mitochondria do is take fuel, in the form of glucose or fatty acids that are delivered by the circulatory system—along with oxygen—and burn it. If they burn carbohydrates they get a certain amount of energy production per gram. If they burn fatty acids, they actually get twice the amount of energy per gram of fuel.
Every cell in the human body is critically dependent on a steady supply of the ATP that the mitochondria produce. However, when they burn fuels—just as if you burn something in your fireplace—any combustion produces toxic products, such as smoke and ash. For mitochondria, the smoke and ash are free radicals. The mitochondria have developed a sophisticated mechanism for detoxifying the free-radical byproducts of energy metabolism, utilizing antioxidant nutrients and enzymes.
The mitochondrial theory of aging and disease holds that as people age, experience high levels of chronic stress, and are continually exposed to toxins in the environment, there is a gradual depletion of mitochondrial antioxidant defenses, which leads to progressive damage to the mitochondria by free radicals—generation after generation of progressive damage first leads to weakened mitochondria then ultimately causes the cell to have fewer mitochondria than it used to have. If this process continues, symptoms of disease develop. This is the field of mitochondrial medicine in which I am performing research.
Supporting this hypothesis are hundreds of studies showing evidence that free-radical levels above normal damage membranes, DNA, mitochondria, and other critical components of the cell, and that to correct this imbalance, you need to supplement mitochondrial nutrients. If you supplement mitochondrial nutrients in the right dosages, the right formula, and the right balance—all of those are critically important to get right—you can bring the entire system of the cell back into balance. The mitochondria no longer become progressively damaged and you actually can start improving the health and functioning of the individual because you have now corrected this very damaging process. That is the bottom line when it comes to mitochondrial medicine—coming up with an effective correction to this problem.
ATHM: In saying that mitochondrial damage is foundational to many manifestations of disease, what is the scope of disease that mitochondrial damage drives?
Dr Kaiser: That is an excellent next question, because the systems that require the most energy to function properly for our well-being are actually the systems that this kind of progressive mitochondrial damage affects the most. Three of those systems would be the nervous system, the immune system, and, somewhat surprisingly to some, the liver.
We all have a finite amount of energy production to fuel all of our body’s needs. A full 25% of our energy goes to support our brain and our nervous system at any given time. It is a very energy-dependent system. The immune system can either be at rest, if you do not have any infection going on, or it can be very active. If you are infected with, let’s say, an influenza virus, one of the reasons you have to crawl into bed and lie down is because your immune system may need upwards of 50% of your energy to fight an acute infection. You do not have energy to do anything else so you need to lie down and be completely at rest for the immune system to properly do its job.
If you have chronic infections, such as dysbiosis or chronic inflammation, the energy demanded by the immune system is high, long-term. Additionally, the liver is energy intensive in terms of processing meals. One of the reasons we become sleepy after a big meal is because the liver and the digestive system need most of your energy.
When chronically dysfunctional mitochondria accumulate in those systems, you first see mild symptoms, and then frank diseases in those systems. In the nervous system, you may have cognitive problems, fatigue, and decreased alertness, initially. But if the mitochondria keep becoming damaged, research has shown this to potentially cause the development of Alzheimer’s, multiple sclerosis, Parkinson’s, and ALS. There is literature published that has found mitochondrial damage and dysfunction present in all of these diseases.
In the immune system, you can start developing immune dysfunction and can get pneumonia or other chronic infections such as Helicobacter pylori. If your immune system starts to wear down, due to this mitochondrial depletion, then all sorts of infectious and inflammatory conditions, as well as autoimmune diseases, can occur.
With the liver, multiple chemical sensitivities or nonalcoholic fatty liver disease can occur if the liver does not have enough energy to process the excess fat and cholesterol. These are systems that are very dependent on healthy, robust mitochondria. These end-organ diseases have all shown evidence of mitochondrial dysfunction.
Let me also say that different individuals may have a genetic component that makes one portion of their bodies more susceptible at the same level of stress and free radicals that their whole body has been exposed to. Because of their genetics, they may manifest the disease first in the brain, if you have family history of Alzheimer’s, or in the liver or in the blood, if you have a family history of leukemia. There is obviously going to be genetic predisposition that determines which of these systems is your weak link.
ATHM: Is there one side of your family whose mitochondrial health is more important to track?
Dr Kaiser: Part of the answer is very clear and part of the answer is not. It is very clear that mitochondrial genes are provided to the developing organisms 100% from the maternal side. If your mother has a mitochondrial genetic disease, you will inherit those genes in the mitochondria because the mitochondria have their own DNA, which is inherited exclusively from the mom.
The part that is a little less clear is when the genetic potential for a disease does not come from the mitochondrial DNA. Let’s say you inherited normal mitochondrial DNA from your mother. However, you inherited the tendency for Alzheimer’s, ALS, or multiple sclerosis from your father. It is your brain neuron, the nuclear DNA of you neurons, that may have a predisposition or a potential for developing Alzheimer’s.
In that individual, if over the course of their life they were exposed to toxins, ate a poor diet, did not consume enough antioxidants, had a high stress job, got chronic infections, and experimented with drugs—in other words they did all sorts of lifestyle things that caused mitochondrial damage, which is easily possible even if you inherited normal mitochondrial DNA—then those neurons are going to be stressed and have less energy and the genes for Alzheimer’s or ALS are going to turn on.
ATHM: Wouldn’t mitochondrial effectiveness also play a pretty large role in cardiovascular health?
Dr Kaiser: The energy requirements of these systems change depending on what is going on, so if you are sitting at rest after a big meal, then your liver and digestive system need the majority of your energy. If you are running a marathon, you are not going to be calculating your taxes. You just cannot do that because your cardiovascular system and your muscles are needing the most energy. It really depends on what your situation and activity level are. Do you have an infection? Have you just eaten a large meal? Are you working to meet a deadline or to take a test in medical school? You can see how the energy requirements of your organ systems are changing all the time.
ATHM: How it might affect the pancreas and manifest as disease?
Dr Kaiser: There is an abundant amount of literature suggesting that adult-onset diabetes is a mitochondrial disease and that, at some point, the pancreatic islet cells cannot keep up with the demand to generate enough insulin, given the person’s abundant intake of sugar over their lifetime. There is probably a genetic predisposition to the pancreatic islet cells being overwhelmed because they do not have enough energy to keep up. It is almost like your body’s energy needs are of the highest priority. If your cells cannot keep up with the energy needs of that particular organ in that particular person at that particular point of time in their life, that is when end-stage organ disease occurs.
ATHM: So then, why isn’t mitochondria health a larger part of the discussion when it comes to addressing chronic disease?
Dr Kaiser: That is the $64 000 question. Let’s start with the big picture: The agenda for modern medicine, medical schools, and medical research is driven by the pharmaceutical industry. Even though there could be a big payoff if pharmaceutical companies would promote research on mitochondrial dysfunction, they have a blind spot to the area of supporting mitochondrial functioning. The reason is because they are used to thinking: “How do we sharpshoot this problem?” Their model is to identify a single synthetic chemical entity to target a single virus, source of infection, or receptor target. You cannot do this with the mitochondria. It won’t work.
The only way to improve the health and functioning of the mitochondria is with a broad-based, natural source of support. Pharmaceutical companies glaze over when you start to talk about micronutrients or about multicomponent formulas. It is not within their model. They do not understand it. They do not think in the proper way to be able to develop a treatment to make mitochondria work better. They have not gone in that direction because they would rather go in more productive directions, where they can sharpshoot a receptor on an immune cell or block an autoimmune disease or block cancer-cell reproduction. That is the model they have chosen to follow.
- Kaiser JD, Campa AM, Ondercin JP, Leoung GS, Pless RF, Baum MK. Micronutrient supplementation increases CD4 count in HIV-infected individuals on highly active antiretroviral therapy: a prospective, double-blinded, placebo-controlled trial. J Acquir Immune Defic Syndr. 2006;42(5):523-528.
- Kaiser J. Immune Power: A Comprehensive Healing Program for HIV. New York, NY: St Martin’s Press; 1995.
- Kaiser J. Healing HIV: How to Rebuild Your Immune System. Mill Valley, CA: HealthFirst Press; 1998.