Energy cannot be produced without Beta oxidation. It is an essential process that occurs in the mitochondria for the production of energy. Cells rely on energy to perform all of the functions they need to perform to keep us alive. Beta oxidation is therefore extremely important but is often forgotten when treating patients. Metabolomics testing can help with that.
Energy is produced from carbohydrates, fats and proteins. Amino acids are usually reserved for other functions, so not much of our energy comes from protein. The body strives to use mostly fat and a little bit of carbohydrate as your source of energy.
If you think back to high school chemistry, you will remember that the process of burning fat is called beta-oxidation. When you are at rest, as you are now, sitting and reading this article, eighty to ninety per cent of your cellular energy is coming from the process of beta-oxidation, assuming you haven’t eaten recently.
Fatty acids pass through the cell membrane into the cytosol, the fluid inside the cell. Palmitic acid is the main fatty acid that is used for energy. For this to be possible it needs to pass through the outer and inner membranes of the mitochondria. But, the movement of fatty acids into the mitochondria is highly regulated. Fatty acids are very big molecules and cannot simply diffuse through the mitochondrial membranes without being transformed first.
Palmitic acid is broken down to form palmitoyl-CoA, which is also too big to cross over the mitochondrial membranes. So, coenzyme A (vitamin B5) is removed and replaced with carnitine, resulting in a much smaller molecule. Carnitineacyltransferase-1 is the enzyme that helps palmitic acid move through the outer mitochondrial membrane. The molecule can then cross through the inner mitochondrial membrane through a specialised shute, the translocase protein, into the mitochondria.
The carnitine is released to go and help another molecule of palmitic acid into the mitochondria and coenzyme-A is reattached. Now the palmitoyl co-A can be burnt up for energy.
It is possible that beta-oxidation is so quickly forgotten because it is a complex process. The brief outline above only covers some of the steps it takes for palmitic acid to become a usable source of cellular energy. There are a lot of different steps involved in the process which means there are a lot of places where things can go wrong. And they do.
The result is that these people will not burn fat very well. They may present to you with depression, weight gain, chronic fatigue and headaches.
The problems stem from the size of the palmitic acid. There is no alternative route to the mitochondria. Only when coenzyme A is replaced with carnitine is the molecule small enough to cross through the mitochondrial membranes. If there is no carnitine, the whole process is going to come to a halt.
When you recognise the importance of beta-oxidation, you recognise the need to test what is happening in the mitochondria. And that is where metabolomics testing comes in.
The test includes markers that tell you whether fatty acids can be transported across the mitochondrial membrane or not. If metabolites such as adipic acid and suberic acid are high, the patient does not have enough carnitine to burn these fatty acids and they have a mitochondrial crisis.
The solution is to give the patient carnitine. The whole process then starts to work properly. Not everyone needs to take carnitine, only those who have high levels of markers that indicate that the mitochondria are in trouble.
Once you understand the importance of beta-oxidation, you will no longer be able to ignore it. Without it, the cells are starved for energy, and the patient starts to suffer from depression, fatigue, weight gain and headaches.
When their metabolomics test results show that they don’t have enough carnitine to support beta-oxidation, you have a simple answer to a complex problem. Giving them carnitine gets the ball rolling. Beta oxidation is restored and they get better.