CoQ10 Benefits for Fibromyalgia, ME/CFS, and Chronic Fatigue

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Nov 26

What is CoQ10 and Why is it Important for Energy and Mitochondria?

Coenzyme Q10 (CoQ10) is a popular supplement often mentioned in research on fibromyalgia, long-haul COVID, and ME/CFS. Many studies suggest that it may help manage symptoms in these conditions, but is it the right choice for you? Let’s explore CoQ10’s benefits, forms, dosing, and research-backed insights to help you make an informed decision.

CoQ10 Benefits for ME/CFS, Fibromyalgia, and Post-Viral Fatigue

CoQ10 is a naturally occurring enzyme produced by the body that plays a vital role in energy production (ATP) within cells. It is also a powerful antioxidant and anti-inflammatory, making it a potential tool for managing post-viral conditions.

Energy Production: CoQ10 protects mitochondria—the energy factories of cells—from oxidative stress, which is particularly important in conditions like ME/CFS, where mitochondrial dysfunction is common.
Age-Related Decline: CoQ10 levels naturally decrease with age, making supplementation beneficial for older adults.
Low Levels in ME/CFS: Research shows that people with ME/CFS tend to have lower CoQ10 levels compared to healthy individuals and even lower than those with depression (Maes, 2009).

While CoQ10 is widely studied for heart disease and heart failure, clinical trials often fail to specify which form is most effective. This has created confusion about the best form to take and the appropriate dosage.

Ubiquinone vs. Ubiquinol: Which CoQ10 Supplement is Better?

CoQ10 supplements come in two main forms:

Ubiquinone: The oxidized form of CoQ10.
Ubiquinol: The reduced, active form of CoQ10.

The body can convert these forms back and forth as needed. Research suggests that ubiquinone is more bioavailable than ubiquinol. However, research is heavily skewed toward clinical trials using ubiquinone. There is nearly a 7-fold higher number of trials using ubiquinone versus ubiquinol. Fortunately, newer formulations ensure better absorption regardless of the form, so the confusion about ubiquinone versus ubiquinol may no longer matter.

Best CoQ10 Formulations for Maximum Absorption

VESIsorb® Technology
VESIsorb® is a cutting-edge delivery system that enhances the absorption of fat-soluble nutrients like CoQ10. In a small study, VESIsorb® increased peak blood levels of CoQ10 by 308% and improved overall absorption by 622% over 10 hours compared to standard oil-based formulations. It also outperformed two other enhanced CoQ10 products by 285% to 499%.

Recommendation: Pure Encapsulations offers a CoQ10 product using VESIsorb® technology, though it can be prohibitively expensive.

Kaneka CoQ10
Kaneka CoQ10 is another well-researched option. Studies involving single oral doses of 150 mg or 300 mg, as well as daily doses of 90–300 mg over four weeks, found it was effectively absorbed and showed no safety concerns.

Recommendation: Researched Nutritionals provides a 200 mg Kaneka CoQ10 formulation at a more affordable price point.

CoQ10 Dosage for Fatigue, Fibromyalgia, and Energy Support

Clinical trials have evaluated doses ranging from 50 mg to 3,000 mg per day. Thankfully, CoQ10 has minimal reported side effects, with mild digestive discomfort being the most common.

Tips for Dosing:

For high doses, divide into smaller doses throughout the day to improve absorption and reduce gastrointestinal irritation.
Take CoQ10 with food containing fat to enhance uptake, as it is fat-soluble.

Research on CoQ10 for Chronic Fatigue and Fibromyalgia

For Fatigue

Small studies suggest that CoQ10 supplementation can improve fatigue in ME/CFS, sometimes in combination with NADH (Tsai, 2022). However, newer formulations with improved bioavailability, as mentioned above, might eliminate the need for combining supplements.

For Fibromyalgia

A systematic review of CoQ10 trials in fibromyalgia patients found that most participants experienced improvements in pain, fatigue, sleep quality, mood, and scores on the Fibromyalgia Impact Questionnaire (FIQ)(Freire de Carvalho, 2024).

My Clinical Experience

Some ME/CFS patients I’ve worked with report little improvement in fatigue using CoQ10. Also, this supplement is often too expensive for patients to trial. However, clinical trials clearly and consistently demonstrate benefits. The discrepancy, I believe, often comes down to the quality of the supplement. Pharmaceutical-grade products tested in research settings are crucial for achieving results, as many over-the-counter options lack purity and potency.

The Bottom Line: Choosing the Best CoQ10 Supplement

To maximize the benefits of CoQ10:

Choose high-quality formulations like Kaneka CoQ10 or VESIsorb®, which have been validated in clinical trials.
Opt for gel caps for better absorption.
Take CoQ10 with a meal containing fat to enhance uptake.
Use pharmaceutical-grade products to ensure purity and efficacy.

Higher doses and longer treatment durations often yield the most significant improvements in symptoms like fatigue. With the right formulation and dosing strategy, CoQ10 can be a valuable tool for managing symptoms in ME/CFS, fibromyalgia, and post-viral conditions. Does it work for you?

By following these guidelines and using evidence-based formulations, you can make the most of what CoQ10 has to offer. Always consult your healthcare provider before starting a new supplement regimen. There may be indications for which CoQ10 supplementation is contraindicated.

Resources

Judy WV. The Instability of the Lipid-Soluble Antioxidant Ubiquinol: Part 3-Misleading Marketing Claims. Integr Med (Encinitas). 2021;20(6):24-28.

Fladerer JP, Grollitsch S. Comparison of Coenzyme Q10 (Ubiquinone) and Reduced Coenzyme Q10 (Ubiquinol) as Supplement to Prevent Cardiovascular Disease and Reduce Cardiovascular Mortality. Curr Cardiol Rep. 2023;25(12):1759-1767. doi:10.1007/s11886-023-01992-6

Maes M, Mihaylova I, Kubera M, Uytterhoeven M, Vrydags N, Bosmans E. Coenzyme Q10 deficiency in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is related to fatigue, autonomic and neurocognitive symptoms and is another risk factor explaining the early mortality in ME/CFS due to cardiovascular disorder. Neuro Endocrinol Lett. 2009;30(4):470-476.

Tsai IC, Hsu CW, Chang CH, Tseng PT, Chang KV. Effectiveness of Coenzyme Q10 Supplementation for Reducing Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Pharmacol. 2022;13:883251. Published 2022 Aug 24. doi:10.3389/fphar.2022.883251

Hansen KS, Mogensen TH, Agergaard J, et al. High-dose coenzyme Q10 therapy versus placebo in patients with post COVID-19 condition: a randomized, phase 2, crossover trial. Lancet Reg Health Eur. 2023;24:100539. doi:10.1016/j.lanepe.2022.100539

Freire de Carvalho J, Skare T. Coenzyme Q10 supplementation in rheumatic diseases: A systematic review. Clin Nutr ESPEN. 2024;59:63-69. doi:10.1016/j.clnesp.2023.11.016

Hosoe K, Kitano M, Kishida H, Kubo H, Fujii K, Kitahara M. Study on safety and bioavailability of ubiquinol (Kaneka QH) after single and 4-week multiple oral administration to healthy volunteers. Regul Toxicol Pharmacol. 2007;47(1):19-28. doi:10.1016/j.yrtph.2006.07.001

Ikematsu H, Nakamura K, Harashima S, Fujii K, Fukutomi N. Safety assessment of coenzyme Q10 (Kaneka Q10) in healthy subjects: a double-blind, randomized, placebo-controlled trial. Regul Toxicol Pharmacol. 2006;44(3):212-218. doi:10.1016/j.yrtph.2005.12.002

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Dr. Craig www.drCourtneyCraig.com