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Coenzyme Q10 Benefits Symptoms in Gulf War Veterans: Results of a Randomized Double-Blind Study, 2014, Golomb et al

Discussion in ''Conditions related to ME/CFS' news and research' started by Hutan, Jul 14, 2023.

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  1. Hutan

    Hutan Moderator Staff Member

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    https://direct.mit.edu/neco/article...-Symptoms-in-Gulf-War?redirectedFrom=fulltext
    paywall I think

    Abstract
    We sought to assess whether coenzyme Q10 (CoQ10) benefits the chronic multisymptom problems that affect one-quarter to one-third of 1990–1 Gulf War veterans, using a randomized, double-blind, placebo-controlled study. Participants were 46 veterans meeting Kansas and Centers for Disease Control criteria for Gulf War illness. Intervention was PharmaNord (Denmark) CoQ10 100 mg per day (Q100), 300 mg per day (Q300), or an identical-appearing placebo for 3.5 [​IMG] 0.5 months.

    General self-rated health (GSRH), the primary outcome, differed across randomization arms at baseline, and sex significantly predicted GSRH change, compelling adjustment for baseline GSRH and prompting sex-stratified analysis. GSRH showed no significant benefit in the combined-sex sample. Among males (85% of participants), Q100 significantly benefited GSRH versus placebo and versus Q300, providing emphasis on Q100. Physical function (summary performance score, SPS) improved on Q100 versus placebo. A rise in CoQ10 approached significance as a predictor of improvement in GSRH and significantly predicted SPS improvement. Among 20 symptoms each present in half or more of the enrolled veterans, direction-of-difference on Q100 versus placebo was favorable for all except sleep problems; sign test 19:1, [​IMG]⁠) with several symptoms individually significant. Significance for these symptoms despite the small sample underscores large effect sizes, and an apparent relation of key outcomes to CoQ10 change increases prospects for causality.

    In conclusion, Q100 conferred benefit to physical function and symptoms in veterans with Gulf War illness. Examination in a larger sample is warranted, and findings from this study can inform the conduct of a larger trial.
     
    Last edited: Jul 14, 2023
    Hutan, Jul 14, 2023
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  2. Hutan

    Hutan Moderator Staff Member

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    I have only read the abstract.

    It's not looking very positive. There was no benefit on the primary outcome (General Self-rated Health), for either 100mg/day or 300mg/day.

    They did some post hoc subsetting, reporting that 100mg/day was associated with a significant benefit, in males. I don't think it makes sense that there would be a real benefit with 100mg/day but not 300mg/day, (unless there was some confounding factor e.g. sample size or differences in baseline characteristics).

    This is a 2014 paper. It says that further research with a larger sample size is warranted, which is fair enough. However, the fact that this paper has been cited in a 2023 paper suggests that such further research either was not done, or if it was, it wasn't published. Either way, it's not suggesting that the researchers felt so excited by this outcome that they thought it was worth attempting to produce definitive proof of efficacy.

    I don't think this paper constitutes evidence of CoQ10 being useful in Gulf War Illness.
     
    Last edited: Jul 14, 2023
    Hutan, Jul 14, 2023
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  3. Amw66

    Amw66 Senior Member (Voting Rights)

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    How many participants were on statins ?
    Statins lower cq10 levels , so supplementation could confer a benefit ?

    Cq10 bioavailability is affected by genetic expression - interacting mutations are common , so responses may have to factor in genetic predisposition . Were genetics studied ?

    Like a lot of things in ME it's something we found helpful for a while , then less so . Ubiquinone v ubiquinol makes a difference too. It may be something where dosage requires titration .

    Conjecture on my part - Effect on males - given interactions with cholesterol then it could affect testosterone levels , a big feel good factor . Conversely affecting hormone levels in females via estradiol might be less of a feelgood factor.

    Structurally it looks a lot like vitamin K ( quinone commonality) , which might be another rabbit hole to jump down ...

    ETA . Cq10 is promoted also as an anti-inflammatory and has been found to improve liver function in those with NAFLD.
    Improving liver function may help excrete toxins which may make you feel a bit better ....

    So a lot of factors which could improve symptoms over a 3-4 month period .
     
    Last edited: Jul 14, 2023
    Amw66, Jul 14, 2023
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  4. DokaGirl

    DokaGirl Senior Member (Voting Rights)

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    Thanks for this @Amw66

    I've used ubiquinol off and on for 9 years. It does seem to help my energy a bit. However, I take quite a bit more than 100mg/day.

    ETA: I didn't initially use ubiquinol for ME.
    The reason I've used ubiquinol off and on, is the price. It's supposedly a more bioavaiable form of CoQ10, but it's expensive.
     
    Last edited: Jul 16, 2023
    DokaGirl, Jul 14, 2023
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  5. Ariel

    Ariel Senior Member (Voting Rights)

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    Anecdotally I have found CoQ10 to be helpful. It didn't do anything when I tried it at lower doses; 800 mg per day was what I used. I now take ubiqinol instead of the regular ones (ubiqionone) and take 200mg of that daily. I find if I stop my chest pain comes back; it really appeared to help with this particular symptom and with being able to tolerate sitting up etc due to my chest. So I keep taking it.

    I wonder if this can be looked at, at higher dosages. I know they have tried it for heart failure patients.
     
    Ariel, Jul 14, 2023
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  6. Hutan

    Hutan Moderator Staff Member

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    High-dose coenzyme Q10 therapy versus placebo in patients with post COVID-19 condition: randomized, phase 2, crossover trial 2022 Hansen et al
    This is a good recent double blinded study of CoQ10 (500mg/day) for Long Covid - they didn't find any benefit, and, remarkably, clearly said so.

    From memory, the studies in ME/CFS have been a lot less well done, but still not suggesting there is any benefit, on average of course. Individual circumstances or perhaps the version of the supplement may make a difference. Here's a thread looking at the evidence of a benefit in ME/CFS and discussing personal experiences:
    CoQ10 - Coenzyme Q10
     
    Hutan, Jul 14, 2023
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  7. rvallee

    rvallee Senior Member (Voting Rights)

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    CoQ10 has come up a lot on LC forums. Not a lot of convincing evidence from there given the wild fluctuations and how unpredictable remissions and recovery are.

    Doesn't seem like a good use of funds, frankly. We need game-changers, not torturing statistical significance for the lowest possible benefit so that someone can publish a paper out of it.

    Publish and perish has really turned into publish and perish in evidence-based medicine, but it's the patients doing all the perishing.
     
    rvallee, Jul 14, 2023
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  8. Hutan

    Hutan Moderator Staff Member

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    I agree. CoQ10 sounds like something that should help, supposedly covering the very common hand-wavey explanations of ME/CFS - inflammation and mitochondrial dysfunction. But there's no evidence that it, on average, does help in any meaningful way. People can sort out for themselves whether they want to spend money on CoQ10 supplements, but I think, at this point with the lack of evidence supporting a benefit despite some studies having investigated it, we need our scarce research funds spent on other things.

    It would help if other researchers didn't cite null findings like this as evidence of CoQ10 helping and go on to build etiological hypotheses on shaky foundations.
     
    Last edited: Jul 15, 2023
    Hutan, Jul 15, 2023
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  9. boolybooly

    boolybooly Senior Member (Voting Rights)

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    CoQ10 is an antagonist against anticoagulants... I recently discovered. If you google there are drug interaction warnings for warfarin everywhere.

    [Interaction between warfarin and coenzyme Q10] 1998
    https://pubmed.ncbi.nlm.nih.gov/9621803/
    In the context of longcovid or whatever it is which is giving me a 6 day cycle of 3 day migraines, 3 days without ... taking CoQ10 has repeatably given me a migraine (for the last 3 attempts consciously monitored), no matter what my cycle is doing, as does eating leafy greens with lots of vit K in them as does taking supps with Mn in. These two factors are considered to be involved in blood clotting and CoQ10 is considered to have a similar structure to vit K.

    Circumstantially it appears my migraines have a thrombotic aspect. I can reduce their severity considerably by taking VitD and Turmeric and omega 3s which are anti-inflammaory and also blood thinners.

    While n=1 is not that interesting for anyone else, I think the point is that the benefit or otherwise of CoQ10 depends a lot on the condition of those taking it. To some it may be nutritious and to others it might be unhelpful.
     
    boolybooly, Jul 18, 2023
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  10. Mij

    Mij Senior Member (Voting Rights)

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    Were the subjects tested to see if they had low levels of COQ10? I'm not sure an RBC test gives an accurate reading, but I read (somewhere) that testing at the cellular level is more accurate.

    My test results for CoQ10 (RBC) was considered 'low' but was in the midrange level on my chart. I did feel some benefit when I took 200mg for 2 months years ago but developed racing heart symptoms and had to stop.
     
    Mij, Jul 18, 2023
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