Mito Stress

Mito Stress is a specialized functional diagnostic tool designed to detect mitochondrial dysfunction and evaluate cellular energy efficiency. This assay is performed on peripheral blood mononuclear cells (PBMCs), which circulate throughout the body and reflect the systemic mitochondrial health status across tissues. Its core biomarker is the Bioenergetic Health Index (BHI), a multiparametric, quantitative indicator of mitochondrial function.

Using specialized kinetic analysis of cellular respiration, performed under baseline conditions and after pharmacological interventions, the test measures dynamic respiratory parameters that are collectively used to calculate the BHI:

• Basal and maximal OCR (Oxygen Consumption Rate)
• Proton leak
• Non-mitochondrial respiration (or Non-mitochondrial OCR)
• ATP-linked respiration
• Spare respiratory capacity

Mitochondria, often referred to as the “powerhouses” of the cell, are organelles responsible for ATP synthesis, thus meeting the body's vital energy demands. Energy production occurs primarily along the inner mitochondrial membrane through oxidative phosphorylation, a process involving electron transport chain protein complexes that culminates in the synthesis of ATP. Dysfunctions in this mechanism have been linked to numerous pathological conditions, highlighting the importance of mitochondrial functional assessment through advanced laboratory testing.

Mitochondrial energy output can be disrupted by a range of pathological states, including oxidative stress (ROS), nitrosative stress (RNS), inflammation, metabolic imbalances, and deregulation of critical cellular processes (e.g., mitophagy, mitochondrial biogenesis, apoptosis). The sensitivity of the Mito Stress assay enables early detection of deteriorating energy capacity, even in the absence of overt fatigue symptoms, by capturing real-time functional information about these mechanisms. Especially under conditions such as inflammation, diabetes, SARS-CoV-2 infection, fatigue, or caloric overload, Mito Stress can detect shifts in the cellular microenvironment that alter mitochondrial efficiency, reflecting both bioenergetic and immune balance within the organism.

Clinical Relevance

The results of the Mito Stress profile have broad clinical applications in functional and integrative medicine, serving both diagnostic and therapeutic monitoring purposes. It is particularly valuable for the early detection of mitochondrial dysfunction in patients presenting with chronic, unexplained fatigue, muscle weakness, reduced physical stamina, and impaired mental clarity, especially when conventional testing fails to reveal pathological findings.

This assessment is instrumental in the context of:

• Chronic Fatigue Syndrome (CFS/ME): provides objective evidence of mitochondrial underperformance, helping distinguish physiological from psychosomatic causes.
• Long COVID/Post-COVID Syndrome: used to investigate persistent fatigue, “brain fog,” and attention deficits linked to sustained energy metabolism impairment.
• Chronic Metabolic Disorders: including type 1 & type 2 diabetes, obesity, and atherosclerosis.
• Neurodegenerative Diseases: such as Alzheimer's, Parkinson's, ALS, and multiple sclerosis.
• Psychiatric and Neurodevelopmental Conditions: including major depression, bipolar disorder, autism spectrum disorder, and ADHD.
• Chronic Overlapping Pain Conditions (COPCs): like fibromyalgia, migraine, and irritable bowel syndrome.
• Sports & Exercise Medicine: especially in cases of unexplained performance decline or overtraining; Mito Stress helps identify cellular energy deficits and guides tailored recovery or training protocols.
• Therapy Monitoring: ideal for evaluating the effectiveness of detoxification protocols, nutritional interventions, and for monitoring recovery from drug-induced disturbances.

Interpretation

The interpretation of the Mito Stress test results is based on the calculation of the Bioenergetic Health Index (BHI), a composite index derived from multiple cellular respiration parameters. The BHI reflects the mitochondria’s overall ability to generate energy and respond to stress. A high BHI indicates optimal mitochondrial function, whereas a low BHI suggests mitochondrial dysfunction, often present even in subclinical stages.

Key parameters assessed within the Mito Stress panel include:

• ATP-linked respiration: Low values may indicate oxidative stress, inflammation, or insufficient availability of metabolic substrates. In contrast, normal values reflect adequate ATP production and efficient mitochondrial performance.
• Proton leak: Pathological elevations are often seen in conditions such as diabetes, overtraining, inflammation, and aging. Mild increases may represent an adaptive response, as seen during winter months or in athletes during periods of improved physical conditioning.
• Spare respiratory capacity: This is a crucial marker of mitochondrial flexibility and resilience. Reduced capacity is commonly associated with chronic stress, ischemia, or metabolic dysfunctions.
• Non-mitochondrial respiration: Elevated values may indicate subclinical inflammation or cellular toxicity, often arising from non-mitochondrial enzymatic pathways such as Cyclooxygenase/Lipoxygenase (COX/LOX). This metric should always be interpreted in the context of other respiratory parameters.

The integration of these parameters and their quantitative interrelationships enables not only diagnostic assessment but also the prediction of impending energy decline, even in asymptomatic individuals. This makes Mito Stress a valuable tool for identifying functional imbalances before clinical symptoms become evident.

Therapeutic Approaches

The Mito Stress test is not merely a diagnostic tool, but also a guide for personalized therapeutic strategies aimed at restoring mitochondrial function. Healthcare professionals can utilize the results of the individual markers provided by the test to design targeted interventions across the following therapeutic domains:

• Physical Activity: Light to moderate exercise stimulates the biogenesis of new mitochondria and promotes the fusion of damaged with healthy ones. At the same time, it reduces proton leak by upregulating uncoupling proteins (UCPs) and helps regulate ROS production.
• Nutritional Interventions: Targeted dietary changes can significantly enhance mitochondrial performance. A hypocaloric or low-carbohydrate diet contributes to reduced oxidative stress. An antioxidant-rich diet, high in vitamins C and E, carotenoids, and polyphenols, supports the neutralization of reactive oxygen and nitrogen species (ROS/RNS). Furthermore, improving the quality of dietary fats by limiting saturated fats and increasing omega-3 fatty acid intake supports mitochondrial membrane integrity and reduces the inflammatory load.
• Supplementation: Mitochondrial antioxidant mechanisms may be supported using coenzyme Q10, niacin (B3), L-carnitine, vitamin D, or other micronutrients, as clinically indicated and following laboratory confirmation of all relevant deficiencies.
• Management of Environmental & Toxic Factors: Eliminating exposure to toxic agents (e.g., pesticides, heavy metals, alcohol, UV radiation) is essential. In some instances, targeted pharmacological treatment may be necessary, particularly in the context of infections or inflammatory conditions.
• Addressing Underlying Conditions: Regulating glucose metabolism, thyroid function, and systemic inflammation is often necessary, as these mechanisms directly impact mitochondrial efficiency and energy production.

The findings of the Mito Stress test reveal both the axis and the degree of cellular dysregulation (e.g., elevated oxidative burden, reduced ATP synthesis, chronic inflammation), enabling personalized therapeutic interventions with predictive value.

Scope and clinical utility of the Mito Stress test

The Mito Stress test is suitable for a wide range of individuals, particularly those experiencing chronic, unexplained fatigue, delayed recovery following viral infections (e.g., COVID-19), metabolic syndromes, neurodegenerative diseases, chronic pain syndromes, or cognitive decline. It is also applicable to otherwise healthy but physiologically burdened individuals, such as high-performance athletes, to prevent energy collapse and optimize physical performance. The test is particularly indicated for individuals who:

• have a history of, or currently suffer from:
  • Chronic Fatigue Syndrome (CFS / ME)
  • Long COVID / Post-COVID Syndrome
  • Chronic Overlapping Pain Conditions (COPCs)
  • Chronic metabolic disorders (e.g., diabetes)
  • Autoimmune diseases
  • Neurodegenerative conditions
• experience persistent fatigue symptoms that remain unexplained despite conventional diagnostic testing
• report severe fatigue that does not improve with standard therapies
• require prolonged recovery periods following infections or surgical procedures
• present signs of depression, burnout, or brain fog
• engage in high-performance athletics, including elite athletes, professionals, or those affected by overtraining syndrome

The unique ability of the Mito Stress test to detect functional alterations at the cellular and molecular levels makes it a valuable tool for predictive, preventive, and personalized medicine.

Last update: 30/10/2025

Mito Stress test is performed by taking a blood sample, which can be done:

• At Diagnostiki Athinon - By taking a blood sample in Diagnostiki Athinon. Book your appointment in real-time and purchase the test online

Important Note: To ensure reliability of the results, the test should not be performed within 24-48 hours of intense physical exertion, febrile illness, or excessive food/alcohol intake.