Coenzyme Q10: Clinical Applications beyond Cardiovascular Diseases, 2021, Testai et al

Andy · Jun 3, 2021

Abstract
Coenzyme Q10 (CoQ10) is an essential cofactor in oxidative phosphorylation (OXPHOS), present in mitochondria and cell membranes in reduced and oxidized forms. Acting as an energy transfer molecule, it occurs in particularly high levels in the liver, heart, and kidneys. CoQ10 is also an anti-inflammatory and antioxidant agent able to prevent the damage induced by free radicals and the activation of inflammatory signaling pathways. In this context, several studies have shown the possible inverse correlation between the blood levels of CoQ10 and some disease conditions. Interestingly, beyond cardiovascular diseases, CoQ10 is involved also in neuronal and muscular degenerative diseases, in migraine and in cancer; therefore, the supplementation with CoQ10 could represent a viable option to prevent these and in some cases might be used as an adjuvant to conventional treatments. This review is aimed to summarize the clinical applications regarding the use of CoQ10 in migraine, neurodegenerative diseases (including Parkinson and Alzheimer diseases), cancer, or degenerative muscle disorders (such as multiple sclerosis and chronic fatigue syndrome), analyzing its effect on patients’ health and quality of life.

Open access, https://www.mdpi.com/2072-6643/13/5/1697

Hutan · Jun 3, 2021

Here's the CFS bit:

CFS is a severe, complex, and highly weakening chronic condition. Today its causes are unknown, as well as diagnostic tests and effective treatments, currently, are focused on the control of disease symptoms. It is characterized by protracted, debilitating, and relapsing fatigue, often accompanied by other symptoms, with significant disability for at least 6 months and often for years [31]. Recent studies revealed that oxidative stress and mitochondrial dysfunction can be associated with its pathogenesis and a reduced rate of ATP synthesis has been reported [32,33,34]. Moreover, clinical reports advise an important role for mitochondrial dysfunction-dependent events and oxidative damage at the cellular level [35]. As CoQ10 and nicotinamide adenine dinucleotide (NADH) increase cellular ATP production through mitochondrial OXPHOS, their supplementation in fatigue, as well as in other symptoms in CFS, is considered a new alternative and complementary therapy [36,37].

Castro-Marrero’s group designed a clinical trial on 73 Spanish subjects (NCT02063126) in which a significant fatigue improvement, measured as decrease in fatigue impact scale (FIS) total score, was observed in the group treated with CoQ10 (200 mg/day) + NADH (20 mg/day) versus placebo. Moreover, a recovery of the biochemical parameters was also reported. In particular, CoQ10, NAD+/NADH ratio, citrate synthase activity, and ATP levels were significantly improved, and the cellular indicators of oxidative stress lipoperoxides, were markedly reduced in mononuclear blood cells of the treated group. Then, the combination of CoQ10 + NADH caused a significant reduction in fatigue, oxidative damage, enhancement of mitochondrial function and improvement of energy [34], leading to the possibility that oral supplementation with CoQ10 + NADH could be beneficial to treat fatigue and act on biochemical parameters in CFS.

More recently, the same authors carried out a further RCT on 80 CFS patients, showing that CoQ10 + NADH supplementation was well tolerated and safe and reduced maximum heart rate significantly at week 8 versus baseline during a cycle ergometer test, supposing that at the basis of this there was an improvement of the endothelial function. Perception of fatigue also revealed a decrease during all follow-up visits in active group versus placebo, but no change in pain and sleep was observed [38].

Finally, Fukuda et al. did not support the efficacy of CoQ10 supplementation (150 mg/day) for 8 weeks in patients with CFS; indeed, no improvement of clinical symptoms was observed. However, the authors reported that a 12-weeks treatment with CoQ10 (150 mg/day) was beneficial for improving sleep quality and autonomic nervous dysfunction as well as better performance on the arithmetic task when compared with the placebo group. Interestingly, the decreases in fatigue levels and depression level were strictly correlated with the increases in ubiquinol concentrations [39].
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Colour me skeptical. I looked at that Castro-Marrero trial and there was only a tiny effect, and the study was sponsored by a supplement manufacturer. We have a thread on CoQ10 for ME/CFS.

Invisible Woman · Jun 3, 2021

Been there, done that 20 odd years ago. Made zero difference. But then I don't really count fatigue as a primary symptom so......

The Fatigue Impact Score is cropping up a lot in the last day or two, isn't it? Many of the questions seem problematic to me and I don't think it gives a fair representation of "fatigue" or anything else. Frankly, quite puzzled as to why anyone who has any in depth knowledge about ME or CFS would.

Wonko · Jun 3, 2021

Tried it several years ago - took many weeks to have any noticeable effect, if it did, and the 'energy' was fake, attempting to use it caused major PEM - but it did feel like I had more lol.

Useful if something was coming up in a few weeks that I had to be able to function for, but expecting those levels of function for longer than a day or 2, forget it.

Over the years I've found, and forgotten, lots of things that can do similar things, useful as a temporary boost provided I'm prepared for the inevitable fall.

I seem to remember CoQ10 was at the more extreme end, sometimes, very effective but the payback was a 'thing' - and of course sometimes it did squat.

Makes no sense to me now, made no sense to me then, haven't used it for a few years at all.

On my 'don't do this' list lol

Mithriel · Jun 12, 2021

I started to take it and thought I felt a bit better but then I went for the weekend to see my son and his family. Three young kids so it was always a challenge but that weekend I felt dreadful with my ME way worse than usual.

When we got home we found the Q10 sitting on the bed where my husband had forgotten to put it into the tablet bag.

Now I think it is a real help to me, not a cure but a help all the same.

Sisyphus · Jun 12, 2021

I was advised that it’s useful to take when also taking statins.

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Coenzyme Q10: Clinical Applications beyond Cardiovascular Diseases, 2021, Testai et al

Andy Committee Member

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Coenzyme Q10: Clinical Applications beyond Cardiovascular Diseases, 2021, Testai et al

Andy Committee Member

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Invisible Woman Senior Member (Voting Rights)

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Sisyphus Senior Member (Voting Rights)

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