Two Curious MD’s Meet a Mitochondrial Pioneer: A Conversation About Life’s Energy Portal
When Dr. Alya Ahmad and Dr. Suraiya Simi Rahman sat down with scientist Sundeep Dugar, PhD on their podcast Too Curious MDs, the conversation explored the tiny organelles that power every living cell on Earth, bridging ancient wisdom with cutting-edge mitochondrial research.
Despite 38 years in pharmaceutical research and co-inventing landmark therapies including Zetia, Dugar carried unmistakable excitement when discussing his latest work on mitochondria. “We’re right at the portal of life,” one host observed as they began exploring how these cellular powerhouses influence everything from aging to mental health.
The Foundation Questions
The MD’s opened with fundamental questions about the origin of mitochondria and what continues to inspire scientific curiosity decades into a distinguished career. Dugar explained that every living species on the planet shares one essential feature: mitochondria. From plants to fish to humans, these organelles perform a task that remains impossible to replicate in a laboratory.
Mitochondria create ATP by combining two highly negatively charged particles, a feat comparable to forcing identical magnetic poles together. The human body produces approximately 150 to 160 pounds of ATP daily, yet cannot store it. Every movement, thought, and heartbeat requires ATP generated on demand in that precise moment. With 45% of cell volume consisting of mitochondria and more mitochondria than cells in the body, their centrality to life becomes undeniable.
When the physicians asked about aging, Dugar shared research showing a 10 to 15 percent loss of mitochondrial function every decade after age 21. This decline affects skeletal muscle, metabolic processes, and overall cellular health, making mitochondrial support relevant across the lifespan.
A Groundbreaking Discovery: The Mitochondrial Steroid
Dugar described his team’s seminal discovery: mitochondria produce a novel endogenous steroid that functions as a signal molecule. This steroid activates specific enzymes through reactive oxygen species (ROS), which serves as a cellular signal indicating increased energy demand rather than being purely damaging.
The steroid activates enzymes that initiate mitochondrial biogenesis, telling mitochondria to produce more mitochondria without cell division. First documented in sea elegans and rats, Dugar’s team was the first to report this mechanism in human muscle tissue and athletes. The breakthrough led to identification of epicatechin, a flavanol that could induce the same cascade of mitochondrial biogenesis.
Mitochondria and Mental Health
The connection between mitochondrial function and mental health particularly resonated with the hosts, given current research trends. The brain represents only 2% of body weight yet consumes 20% of energy supply, making brain function especially vulnerable to mitochondrial deficits.
Dugar raised an important point often overlooked in psychiatric care: many commonly prescribed medications may affect mitochondrial function. SSRIs have documented mitochondrial effects that rarely enter clinical discussions. Meanwhile, emerging treatments like ketamine act at the mitochondrial level through mTOR pathways, and psychedelic compounds show mitochondrial stimulation effects. This represents a paradigm shift in understanding mental health interventions.
The body prioritizes critical organs when allocating energy. “Your body makes decisions to live first, language and cognition second,” Dugar explained. This biological hierarchy helps explain why mitochondrial dysfunction may manifest as cognitive and mood disturbances before other symptoms appear. For pediatric patients facing unprecedented toxic stress, mitochondrial support offers a tool to address the direct consequences on cellular energy production.
From Mayan Messengers to Modern Applications
Dugar shared the story behind BlueOakNx’s flagship product. Mayan culture reserved cacao extract for royalty and messengers. Research with mice on treadmills revealed why: the flavanol supported endurance, allowing messengers to run village to village without exhaustion because their mitochondria functioned more efficiently, not because muscles were stronger.
The physicians asked about clinical applications. Studies have examined effects in diabetes, cardiomyopathy, kidney function, neuromuscular disorders, and mental health conditions. Dugar noted that results vary by individual, with research focused on real-world data rather than contrived outcomes.
Building a Scientific Community
The hosts emphasized the collaborative nature of the work. When asked how listeners could engage, Dugar’s response reflected his approach: visit the website, ask questions, and join the conversation. “It’s not about take one and feel good in the morning. Let’s have a conversation.”
The closing words captured what made this discussion meaningful: rather than focusing solely on pathology, medicine should “build the beautiful, build what’s good already.” The conversation demonstrated how science advances through questions, collaboration, and willingness to explore connections between disparate fields, opening new possibilities for understanding how life sustains itself at the most fundamental level.