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Coenzyme Q10 and chronic fatigue syndrome

Chronic fatigue syndrome is a life-changing condition without many effective treatments. Could daily supplementation with coenzyme Q10 be a simple way to improve symptoms?

Study under review: Ubiquinol-10 supplementation improves autonomic nervous function and cognitive function in chronic fatigue syndrome

Introduction

Think back to a period in your life when you were utterly exhausted. Not just “tired,” but walking around like a zombie, wanting to lay down on the couch and instantly fall asleep at any time of the day. Now imagine feeling like this for six months straight, or even longer. This is what people dealing with chronic fatigue syndrome (CFS) experience. CFS is known by many names, including systemic exertion intolerance disease (SEID), myalgic encephalomyelitis, and chronic fatigue and immune dysfunction syndrome (CFIDS), none of which should be confused with the mythical diagnosis of adrenal fatigue. CFS is thought to afflict 0.26 to 0.78%[1] of the U.S. population, roughly 800,000 to 2.5 million people. The causes of this syndrome have been hotly debated[2].

One proposed hypothesis suggests[3] that CFS is influenced by how well the hypothalamic–pituitary–adrenal axis (HPA) is functioning. All three of these organs, the hypothalamus (a region of your brain), the pituitary gland (attached to the base of the hypothalamus) and the adrenal glands (which sit on top of your kidneys) play a role in regulating the stress response. Ramp this system up too high and you will feel anxious all the time. Turn it down too low and you feel constantly lethargic and become susceptible to illness. Another hypothesis suggests[4] that some sort of immune abnormality is causing a pro-oxidative inflammatory response. This could interfere with CoQ10 production, which the body uses to help produce energy. These are just two of many theories. No one knows for certain what the causes of CFS are.

To date, reviews of treatment options have suggested that cognitive behavioral therapy[5] and graded exercise treatment[6] can reduce fatigue. Neither of these treatments are curative, but are centered around symptom management and improvement. Since the exact mechanisms of CFS are, as of yet, unknown, researchers are testing various hypotheses about the root causes of the disease. One such line of research has investigated the use of supplemental coenzyme Q10 (CoQ10).

CoQ10 is an antioxidant that can influence the production of ATP, the body's energy currency. Our bodies are able to synthesize most of the CoQ10 we need, but we also get some from food, such as beef, broccoli, and eggs. The CoQ10 content of selected other foods is shown in Figure 1. Researchers conducting previous studies have observed markedly lower levels of CoQ10[7] in people with CFS, so it stands to reason that these low CoQ10 levels may be preventing the body from producing adequate amounts of ATP, and thus causing fatigue. One other study noted an improvement in CFS fatigue symptoms when CoQ10 was added to the diet[8], but may have been confounded by addition of supplemental NADH as well. The study under review extends this line of research by examining the effects of ubiquinol-10, a lipid-soluble form of CoQ10, on clinical outcomes in patients with CFS.

Figure 1: CoQ10 content in food (per 120g serving)

Adapted from: Crane FL. J Am Coll Nutr. 2001 Dec.

Chronic fatigue syndrome is a condition of excessive fatigue lasting longer than six months. While the precise causes of CFS are unknown, one line of research has observed low levels of CoQ10 in patients with CFS. One study has shown symptom improvement with supplemental CoQ10, and the present study is furthering this research by examining the effects of ubiquinol-10, a form of CoQ10, in patients with CFS.

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