Supplement prescribing in primary mitochondrial disease is almost universal, yet highly individualised, stepwise, and non-uniform across regions and phenotypes, with real potential for tissue and pill-burden harm. This podcast features Dr Julia Neugebauer and Professor Shamima Rahman exploring findings of a recent MetabERN survey looking at what informs when clinicians start, monitor, and sometimes stop enzymes and co-factors, and how global registry and natural-history data may guide the field forward.

Current global vitamin and cofactor prescribing practices for primary mitochondrial diseases: Results of a European reference network survey

Julia Neugebauer, et al

https://doi.org/10.1002/jimd.12805

And the editorial discussed:

Should the "mitochondrial cocktail" be a default option? An opinion

Peter W Stacpoole, Stephen D Cederbaum

https://doi.org/10.1016/j.ymgme.2025.109264