Alternative Medicine
ATP - The Molecule of Energy

For those who suffer from any kind of chronic illness, there is a strong desire to explore deeper into the mystery of their problem, get to the core of the illness, and discover the path back to health. While this may sound obvious, the first step in overcoming fatigue and maximizing energy is to set one's intention for healing. For some, the healing journey is short, but for many, it's a journey that can take years. In this quest, you have to become as educated as possible.

People bounce around from one doctor, or healthcare practitioner, to another, often getting little real benefit for a chronic health problem. Conventional medicine is best at diagnosing and treating emergencies of all sorts, but is not so good at treating chronic illness. Alternative Medicine is best at treating chronic illness – and curing it. It's important, with any serious health condition, to be evaluated through conventional medicine, lab work, etc. to make sure you don't have a health issue, like hypothyroidism, which can conventional medicine can successfully treat.

For years, in this column, we have discussed a number of tests and new concepts that contribute to the healing of chronic illness. Understanding amino acid chemistry, how to treat food allergies, leaky gut, blood sugar problems, candidiasis, adrenal exhaustion, and inflammation has added to our ability to treat “hopeless” situations.

While nutritional testing yields gratifying results, some patients' recovery is slow and incomplete. So we continue to dive deeper into the inner workings of our cells. A quick review of the 3-step Health Map will help you understand almost any chronic health issue you have.

Step 1: What are the primary causes? These include infections, toxins, malabsorption, protein deficiency, genetics, stress, and more.

Step 2: How the body responds to primary causes, namely through inflammation and the stress response.

Step 3: Metabolic Chaos, or disturbances of Total Body Chemistry.

Chronic health problems are like a cascade of falling dominos, and there are at least 500 “dominos” that we can test for that are part of this illness cascade. This article focuses primarily on the very end of the cascade. Step 3, Total Body Chemistry, is really made up of many layers.

The Molecule of Energy

Ultimately, the problems at all 3 levels gang up to collapse the production of ATP, the molecule of energy, which is produced in our mitochondria (the energy factories within our cells). The Krebs Cycle is the biochemical process that produces ATP. It is the fundamental mechanism for creating energy.

Every time our body builds a protein, hormone, enzyme, neurotransmitter, or anything else, energy is required. That energy comes in the form of ATP, the molecule of energy. Similarly, whenever we are breaking compounds down or detoxifying anything, energy is required to do that work, and ATP provides that spark of energy. ATP's energy is required for everything, which is why 80% of the oxygen we breathe is burned in the Krebs Cycle in the production of ATP.

Our Energy Factory

We can now accurately measure the Krebs Cycle. I first studied the Krebs Cycle in high school chemistry, again in college and then finally in medical school. Thirty-three years after medical school, book study has turned into vital knowledge for my patients. There is exciting new information that is helping to heal people whose healing process has been stuck.

To understand the Krebs Cycle, visualize a circle with eight points. The Krebs Cycle is like an 8-cylinder car engine. Each of those eight points is a chemical, an organic acid, which is essential to the creation of energy. Those eight organic acids are citrate, cis-aconitate, isocitrate, alpha-ketoglutarate, succinate, fumarate, malate, and oxaloacetate.

Glucose is a major source of energy throughout he body. When glucose enters our cells, it is taken to the mitochondria where it is converted into pyruvic acid. Pyruvic acid is then “dropped” into the Krebs Cycle where it kicks off the energy-producing process, starting the 8-cylinder engine, and lighting the fire within our cells. Each time the Krebs Cycle “makes one turn,” ATP is created. ATP is the fire in our cells, the spark that makes our entire body come alive with energy.

While it is not necessary for you to remember the eight points or organic acids within the Krebs Cycle, it is important to know that we now have blood and urine tests that allow us to go into the mitochondria and discover which, if any, of those eight points are deficient.

Energy Blockade

With that image in mind, of the 8-cylinder engine called the Krebs Cycle, let me reveal a couple of very important secrets, the knowledge of which allows us to truly alleviate suffering. First of all, there are various compounds that can jam up the Krebs Cycle, like throwing dirt into the gas tank of your car. At nearly every step in the Krebs Cycle, various heavy metals will either slow down or block a step. Metals like lead, mercury, cadmium, arsenic, and antimony, when present in excessive amounts in our body, can turn the powerful 8-cylinder engine of ATP production into a crippled machine. Heavy metals are the dirt that many of us have in the gas tank of energy chemistry. For some people, it is essential to go through some process of chelation and detoxification to get the metals out, and free up the production of energy.

Nutrients that Create Juice

While heavy metals slow down or block the Krebs Cycle, on the other hand, there are a variety of nutrients that are essential to keep the Krebs Cycle busy producing ATP. Some of those important co-factors are B vitamins, magnesium, L-carnitine, and glutathione (GSH).

Now that you've read this far, it's time to tell you that this article is really about GSH, and a related biochemical reaction. GSH is a multipurpose compound. 1) It is an essential co-factor for the Krebs Cycle, 2) It's one of 5 main anti-oxidants, 3) It protects our DNA from the aging effects of ultraviolet light, and a variety of other forms of invisible wave forms (microwaves, UV, EMF's).

The Methylation Blockade

Since about 1988, those of us working with chronic fatigue syndrome have been aware of the importance of a GSH deficiency, as well as how to restore healthy levels. Now, put back on your chemistry hat for a minute. It turns out that GSH production requires healthy functioning of the “Methylation Pathway.” If the methylation pathway is blocked, there will be a dramatic decrease in the production of glutathione (GSH), as well as the ability of GSH to work.

Over the last five years, researchers in autism discovered that a blockade in the methylation pathway is one very important key to understanding and treating autism. Several researchers in chronic fatigue syndrome (CFS) were keeping an eye on autism and methylation problems and were wondering if there was a methylation blockade in CFS. It turns out that in CFS and other fatigue states, a methylation blockade is present in a very high percentage of patients.

You don't have to know the details of methylation chemistry. Here is what you need to know about lab tests for the Krebs Cycle, ATP, and hence your overall health and energy:

1. The Krebs Cycle can be tested for through a urine test for Organic Acids.

2. There's a blood test for glutathione.

3. There's a blood test with 12 sub-tests that analyzes the Methylation Pathway. Glutathione is actually part of Methylation testing, so it does not have to be a separate lab test.

4. We can test for heavy metals that jam the Krebs Cycle. We can test for heavy metals through hair analysis, urine, and blood.

If a Methylation Blockade is present, GSH will be impaired, and the production of ATP will go down the drain. Here is the good news. If a person does have a blockade in the methylation pathway, there are 5 or 6 nutritional supplements that will remove that blockade. As soon as that happens, the body begins making GSH… and then the Krebs Cycle resumes functioning as the smooth, efficient biochemical engine of energy.

This piece of information about GSH and the methylation pathway is important. Many people who have struggled with chronic illness, including CFS, have spent a fortune, visited 10, 20, or 30 doctors, may have improved for awhile, and then slid back downhill. It's a depressing and despairing situation for many people. The fact is that no matter how many wonderful nutrients or medications a person is taking, if they have a methylation blockade, it has to be treated. There is really no getting around it, and it turns out to be a rather simple thing to figure out through lab work.

You could have all of your vitamins, minerals, amino acids, and essential fatty acids in perfect balance . . . and still be very sick. If the Krebs Cycle is not turning around smoothly, if it is lacking just one “point,” your cells cannot and will not be able to produce enough energy for you. And if you are stressed emotionally or physically, and your system is constantly stressed, the Krebs Cycle will be even more out of balance and overly taxed.

A Krebs Cycle defect can cause chronic fatigue syndrome, fibromyalgia, muscle weakness, headaches, joint pain, general malaise, depression, and poor exercise tolerance. Or you might be sick all the time, picking up every virus that comes near you. Once you know your Krebs Cycle defects, the treatment becomes targeted and powerful.

From Despair to Hope

Most people who come to an alternative physician have already seen numerous doctors. One new patient with chronic fatigue syndrome had seen thirty doctors and other health care practitioners. She said to me, “I had a complete workup at the Mayo Clinic in Rochester, Minnesota and they could not find anything wrong on any of those tests.” I replied, “The fact that you went to a famous hospital with famous doctors means nothing. They are still running the same standard tests that are routine for allopathic doctors, and they're coming up with the same negative results, and probably telling you it's all in your head. Our problem is not going to be that we won't have positive lab findings. Our problem will be that we will have almost too much data to work with. I will have to carefully analyze all that positive data to come up with the most salient and critical elements of your treatment. If you've been sick for a while, nutritional and metabolic lab work will reveal quite a number of treatable abnormalities.”

No matter how sick you are, there is great relief in having lab data that agrees with how you feel. The complexity of the human organism has so often been reduced to the phrase, “You're depressed, you need Paxil,” one would think that Americans are now being born with a Paxil deficiency.

Let's quickly review the sequence of events as it relates to energy chemistry:

1. ATP, the molecule of energy, is produced in a biochemical process called the “Krebs Cycle.”

2. Glucose, or blood sugar, is the main fuel for the Krebs Cycle.

3. There are a number of nutrients that are important co-factors for the Krebs Cycle, glutathione being one of the most important.

4. Glutathione is deficient in a number of health problems, especially energy illnesses, like CFS.

5. Glutathione chemistry is tightly linked to the Methylation Pathway. If there is a Methylation blockade, glutathione will be deficient or inactive.

Having enough ATP is not just about feeling energetic. Because we require ATP to create everything in our body, by unraveling the secrets of energy chemistry, we're able to target our treatment approach, and help people whose physical recovery has stalled. In addition, maintaining a healthy Krebs Cycle and healthy amounts of ATP is important for health, wellness, and longevity.

David Gersten, M.D. practices Nutritional Medicine and Integrative Psychiatry out of his Encinitas office and can be reached at 760-633-3063. Please feel free to access 1,000 on-line pages about holistic health, amino acids, and nutritional therapy at


Transformational Talk:
Owning your shadow

Do you know how to take responsibility for your shadow? I'm not speaking here about that dark imprint trailing behind when you walk in the sun. No, I'm talking about those darker inner aspects (like revenge, rivalry, avarice, arrogance, mendacity, etc.) most would rather not acknowledge at all. Although denying your shadow may help you feel superior about yourself in the short run, you can't take responsibility for something you don't see. The problem is owning your shadow requires facing and healing your less than noble self…a challenge for anyone.

Here's the tip. The first crucial step is to make a decision to resist judging yourself. You have no choice about having these dark aspects; they come with the territory of being human. Drop into your heart and wait until you feel tenderness for your agonizing humanness. Beneath each sinister side is a deep unmet need. When ready, take a look at something you don't like about yourself. Be gentle. Ask yourself what you need. It's okay to cry. It hurts to touch sore places. Breathe. You'll relax as you feel compassion for yourself expanding.

Look for ways to meet your need. Give to yourself now and discover self-protection beneath revenge, pursuit of excellence beneath rivalry, self-care beneath avarice, confidence beneath arrogance, and grace beneath mendacity. Each time you face your shadow, be grateful for another opportunity to turn on your light. ©

Penelope Young Andrade, LCSW Call: 858-481-5752 fax: 858-484-8374 email: